Calcaneal apophysitis, also known as “Sever’s Disease”, is inflammation of the physis (growth plate) in the posterior calcaneus (heel bone). It is one of the most common causes of heel pain in children usually occurring between the ages of 8-14 years old. The growth plate is situated at the back of the heel near the insertion of the Achilles tendon. It is not fully developed until 14 years old, therefore, this area is very prone to overuse injuries. Constant stress from the pull of the Achilles tendon, as well as repetitive pounding during activity, leads to inflammation of the growth plate and surrounding tissue. Children that are most at risk for calcaneal apophysitis are those participating in basketball, soccer, and/or track.
Additional risk factors include a tight Achilles tendon, obesity, flat feet, or high arched feet.
Symptoms often include pain to the back of the heel, feeling of being “tired”, pain with running/jumping, or pain with compression of the heel. It is a self limiting condition and resolves at “closure” of the growth plate, usually around 14 years old. Therefore, treatment is usually symptomatic in nature and geared towards controlling inflammation and pain. Some treatment options include: NSAIDs (non steroidal anti-inflammatory), oral steroids, stretching, physical therapy, custom orthotics, immobilization in walking boot or lower leg cast, and activity modification.
Written by Dr Beau Willis, AACFAS