Adolescent Heel Pain - Severs Disease

Sever's disease is the most common cause of adolescent heel pain that we see in our clinic. It's a self limiting condition, characterised by pain around the rear and/or sides of the heel bone. Pain comes on with activity but is often worse when cooling down after exercise. Sever's usually presents around the ages of 8-15 years old in children who participate in high impact sports like soccer, football and gymnastics.

Physiology:

Sever's disease is a repetitive stress injury to the growing section of bone in the heel (metaphysis). Stress is caused from repetitive tractioning at the attachment of the calf muscles onto the heel bone known as the achilles tendon. In adults, these types of repetitive forces may cause 'tendonitis', but in children and adolescents, the growing bone is relatively weak and more prone to injury.

Although there is no 'cure' for Sever's, it will go away with time. It can typically last up to 12 months and often effects both heels. Once the area of bone has completed its growth, pain will go away. There has been no demonstrated long term consequences of Sever's disease.

Management:

We describe this condition as 'self limiting', meaning that the athlete is in control of how much pain they're willing to work into. Whilst treatment is always individualised, the common management strategies are:

• Heel inserts (these help to reduce the tractioning force of the Achilles on the heel bone)

• Activity modification

• Biomechanical corrections

• Ice for pain relief

• Foam rolling or stretching if tolerated

• Massage

• Strengthening of the calf muscle once pain free

If you or someone you know is struggling with Sever's disease call us on 0499 037 569 to book in for an assessment. You can also book online at www.warringahphysio.com.au/book-now.