Calcaneal Apophysitis AKA Sever’s Disease

Tenderness of the back aspect of the Calcaneus (heel bone) in children age 8-14 years old. The area that is painful is the growth plate of the heel which results in pain and inflammation of the growth plate. The growth plate does not fuse (fully form) till around 14 years old. Pain and inflammation can resolve prior to 14 years old. Calcaneal Apophysitis is the most common form of heel pain in children.

Causes
Running, jumping, soccer, basketball are more of the common sports. Non supportive shoes on hard surfaces are common causes of the heel pain. Altered biomechanics of the feet also contribute to the pain like high or low arch feet, tight Achilles tendon.

Symptoms

• Pain of the back/bottom of the heel

• Tender with squeezing of the area

• Sore to walk, run, jump

• Avoid heel toe gait and walk mostly on the forefoot

Diagnosis

History and physical examination is performed. The Podiatrist will specifically perform a biomechanical examination of the foot and ankle both standing, walking and sitting to examine the foot and ankle position. Palpation of the foot especially the painful area. Possibly order x-rays. If not resolving with usual conservative measures further imaging or blood work may be ordered.

Treatment

• Change shoe gear to a jogging shoe with increased heel toe drop Reduce or stop activity

• Heel pad

• Custom orthotics

• Stretching

• Medication

• Immobilization-cast