Severs Disease is common on children

There are numerous causes of heel pain in adults, but in children the commonest by far is a problem known as Severs Disease. Because this is an injury to the growing plate at the back of the heel bone, it would not happen in adults. The most typical age of coming on is around the early teenage years or maybe a bit before. When we are born the heel bone grows from two locations, one being the main body of the heel bone and the other being the growth area at the back of the heel bone. These two zones of bone are split up by an area of cartilage. Severs disease happens when there is excessive stress on that area of cartilage.

The main causes are simply excessive activity done to rising rates so that the bone doesn't get a chance to get used to the pressures that are placed on the bone. Most typically the child is involved with lots of sporting activity, typically on hard surfaces. Limited calf muscles are also frequently present. The primary symptom is pain around the edges of the heel bone at the back of the heel and pain on activity. Increasing the level of sporting activity also should make it more painful.

The key approach to its management is a decrease in physical activity to ensure that load on the growing region of bone is decreased. Commonly a soft heel raise is needed to safeguard the area and lower the force from the Achilles tendon. Ice after activity to help with pain can be useful. If this is not working well, a further cut in the amount of physical activity is required and in the most stubborn cases, a walking splint or cast can be used to substantially reduce activity levels. If all this does not help, which it occasionally does, then it is just a matter of managing it until the two areas of growing bone merge to form one and this will no longer be an issue.


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