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Pediatric Sever’s Disease Care Pune
Get advanced Sever’s disease treatment in Pune with pediatric orthopedic specialists providing heel pain relief and rehabilitation programs.
Overview
Sever’s disease, medically known as calcaneal apophysitis, is one of the most common causes of heel pain in physically active children and adolescents. Despite its alarming name, this condition is not actually a disease but rather a temporary inflammation of the growth plate located in the heel bone (calcaneus). This growth plate inflammation typically affects children between 8 and 14 years old, coinciding with periods of rapid growth when bones develop faster than surrounding muscles and tendons.
The condition is particularly prevalent among young athletes who participate in running and jumping sports. Understanding Sever’s disease is essential for parents, coaches, and healthcare providers, as early recognition and proper management can prevent prolonged discomfort and help children maintain their active lifestyles safely.
Symptoms
The primary symptom of Sever’s disease is heel pain that develops gradually and follows specific patterns. Children experiencing this condition typically report:
- Pain at the back or bottom of the heel, which may affect one or both feet
- Heel pain that worsens during physical activities like running, jumping, or walking
- Pain that improves significantly with rest
- Tenderness when the sides of the heel are gently squeezed
- Limping or walking on tiptoes to avoid putting pressure on the affected heel
- Mild swelling or redness around the heel area
Causes
Sever’s disease develops due to growth plate inflammation in the heel bone. During childhood and adolescence, bones grow at a faster rate than the surrounding muscles and tendons, particularly the Achilles tendon. This growth mismatch creates tension and repetitive stress at the point where the Achilles tendon attaches to the heel’s growth plate, leading to irritation and inflammation.
Several factors contribute to the development of calcaneal apophysitis:
- Repetitive impact activities such as running, jumping, and sudden direction changes
- Rapid growth spurts that increase tension on the heel’s growth plate
- Tight calf muscles or Achilles tendon that pull on the heel bone
- Poor or worn-out footwear that fails to provide adequate support and cushioning
- Hard playing surfaces that increase impact stress on the feet
Risk Factors
Certain factors increase a child’s likelihood of developing Sever’s disease:
- Age: Most common between 8 and 14 years during peak growth periods
- Physical activity level: Participation in high-impact sports like soccer, basketball, gymnastics, or track and field
- Foot structure abnormalities: Flat feet, high arches, or excessive foot pronation can alter foot mechanics
- Body weight: Higher body weight increases the load and stress on the heel
- Previous heel injuries: Past trauma can make the growth plate more susceptible to inflammation
- Rapid growth spurts: Periods of quick height increase create additional stress on developing bones
Diagnosis
Diagnosis of Sever’s disease is primarily clinical, based on the child’s symptoms and physical examination findings. Healthcare providers typically follow these steps:
- Medical History: The doctor will inquire about the onset, duration, and characteristics of the heel pain, recent growth spurts, activity levels, and any previous injuries.
- Physical Examination: The physician will assess for tenderness by gently squeezing the sides of the heel (positive squeeze test), check for swelling or redness, and evaluate the child’s gait and foot structure.
- Imaging Tests: X-rays are usually unnecessary unless other conditions like fractures or infections are suspected. When performed, X-rays may show normal age-related changes in the growth plate but are not diagnostic for calcaneal apophysitis.
Types
Sever’s disease can be classified based on which heel is affected:
- Unilateral: Affecting only one heel
- Bilateral: Affecting both heels simultaneously, which occurs in approximately 60% of cases
The condition’s severity can also vary, ranging from mild discomfort during intense activities to significant pain that interferes with daily activities and sports participation.
Treatment
The primary goal of treatment for Sever’s disease is to relieve pain and reduce growth plate inflammation while allowing children to remain as active as possible. Since this condition is self-limiting and resolves once the growth plate closes, treatment focuses on conservative management approaches.
Immediate Treatment Options:
- Rest and activity modification: Reducing or temporarily stopping activities that cause heel pain
- Ice therapy: Applying ice packs to the heel for 15-20 minutes several times daily to reduce inflammation
- Pain management: Over-the-counter medications like acetaminophen or ibuprofen as recommended by healthcare providers
Ongoing Management Strategies:
- Stretching exercises: Regular gentle stretching of calf muscles and Achilles tendon to relieve tension
- Supportive footwear: Wearing well-cushioned, supportive shoes with proper heel support
- Heel cups or orthotic inserts: Additional cushioning and support as recommended by healthcare providers
- Physical therapy: For persistent cases, professional guidance for exercises to improve flexibility and strength
Surgical intervention is never required for Sever’s disease, as the condition resolves naturally with time and conservative management.
Rehabilitation
Rehabilitation focuses on safely returning children to their normal activity levels while preventing recurrence. The process typically involves:
- Gradual Return to Activities: Once heel pain has subsided, children can slowly resume sports and physical activities, gradually increasing intensity as tolerated without pain recurrence.
- Continued Stretching and Strengthening: Maintaining flexibility in calf muscles and Achilles tendon through regular stretching exercises and strengthening programs.
- Education and Prevention: Teaching children and parents about proper warm-up routines, appropriate footwear selection, and recognizing early warning signs of growth plate inflammation.
Complications
Sever’s disease has an excellent prognosis with minimal complications when properly managed. However, potential issues may include:
- Chronic heel pain if the condition is ignored and high-impact activities continue without adequate rest
- Altered gait patterns or persistent limping due to ongoing pain, which can affect overall mobility and potentially lead to other musculoskeletal problems
- Recurrence: Symptoms may return during subsequent growth spurts, though this does not cause permanent damage
It’s important to note that calcaneal apophysitis does not lead to long-term structural problems or permanent damage to the heel bone.
Prevention
While Sever’s disease cannot always be prevented, several measures can significantly reduce the risk:
- Gradual activity progression: Encouraging gradual increases in training intensity and duration rather than sudden spikes
- Regular stretching routine: Promoting daily stretching of calf muscles and Achilles tendon
- Proper footwear: Ensuring shoes provide adequate support, cushioning, and fit appropriately
- Early symptom recognition: Monitoring for early signs of heel pain and addressing symptoms promptly
- Healthy weight maintenance: Reducing stress on developing feet through appropriate nutrition and activity
- Surface awareness: Limiting activities on hard surfaces when possible and using appropriate protective equipment
Living With Sever's Disease
Most children with Sever’s disease recover completely and return to their usual activities without long-term problems. During the recovery period, families should:
- Maintain Open Communication: Keep coaches, teachers, and activity leaders informed about the child’s condition and any necessary activity limitations.
- Encourage Alternative Activities: Promote participation in low-impact activities such as swimming or cycling if heel pain prevents running or jumping sports.
- Follow Treatment Plans: Adhere to recommended treatment strategies and avoid pushing through pain, as this can prolong recovery time.
- Practice Patience: Understand that symptoms may persist for several weeks to months but will resolve as the growth plate matures and closes.
Key Takeaways
- Sever’s disease is a common, temporary condition causing heel pain in growing children, particularly those active in sports
- The condition results from growth plate inflammation due to repetitive stress and rapid growth, not from any serious underlying disease
- Diagnosis is primarily clinical, focusing on symptoms and physical examination rather than imaging studies
- Treatment emphasizes conservative management including rest, ice therapy, stretching, and supportive footwear
- The condition is self-limiting and resolves completely once the growth plate matures, typically causing no long-term complications
- Early recognition and proper management at specialized facilities like Sancheti Hospital can help children maintain active lifestyles while recovering safely from calcaneal apophysitis
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Patient Stories & Experiences
The pain in my left knee left me feeling helpless for years. After my treatment here, I can finally say I'm pain-free.
Vinita Singh
The nerves were swollen, and the body went numb. But thanks to Sancheti Hospital, I got a second life!
Parvati
I finally could walk again, a relief I've only felt after the hip pain surgery. I thank the doctors at Sancheti Hospital for their help.
Balaji Kharat
I'm a police officer, and I'm extremely thankful to Sancheti Hospital for treating my fracture without surgery.
Shantilal
My life has completely changed after the knee replacement surgery at Sancheti Hospital. It's like I can finally live again!
Kalpana Lepcha
The knee pain I've carried for years finally went away with the help of Sancheti Hospital.
Karuna
I can't believe that I get to finally live a normal and happy life, all thanks to the knee surgery I had at Sancheti Hospital.
Kishore Bhosle
Frequently Asked Questions
Is Sever's disease permanent?
No, Sever’s disease is a temporary condition that completely resolves once the heel’s growth plate matures, usually by the mid-teen years.
Can my child continue playing sports with Sever's disease?
Children can often continue low-impact activities, but high-impact sports should be limited if they cause heel pain. Rest and gradual return to activity are essential for proper recovery.
Does Sever's disease cause long-term problems?
Calcaneal apophysitis does not cause permanent damage. Most children recover fully with no lasting effects on their heel function or structure.
How long does recovery take?
Symptoms typically improve within a few weeks to months with appropriate management. The condition resolves completely when growth is finished.
When should we see a doctor?
Consult a healthcare provider if heel pain is severe, persistent, or associated with swelling, redness, or difficulty walking, to rule out other causes and confirm the diagnosis.
