As a parent of an active child, aches and pains associated with regular activity and growth are a frequent complaint, with heel pain often a recurring theme. The worrying part for any parent is not knowing when this discomfort has progressed into a specific condition known as Sever's Disease.
Unpacking Sever's Disease
In medical terms, Sever's Disease is correctly known as Calcaneal Traction Apophysitis. This name refers to inflammation occurring at the growth plate (apophysis) of the heel bone (calcaneus), where the Achilles tendon and plantar fascia attach. This inflammation can cause significant pain and discomfort, often limiting a child's ability to walk, run, or participate in their favourite sports or activities.
This condition is most commonly diagnosed in children aged between 8 and 14, particularly those involved in high-impact sports such as netball, soccer, rugby, gymnastics, and basketball. These activities place considerable stress on the heels, which can lead to irritation and inflammation of the growth plate. Symptoms typically emerge 2–6 weeks after a sudden increase or change in activity levels.
The Development of Sever's Disease
Sever's Disease typically occurs when your child's growth plate, which is softer and less developed than adult bone, becomes irritated by the pulling force of the plantar fascia and/or Achilles tendon. This tension can lead to premature bone remodelling, weakening the bone's ability to manage ongoing stress.
Left untreated, Sever's Disease can lead to significant pain, altered bone development, and even microfractures. While it may be challenging to prevent onset entirely, encouraging periods of rest, discouraging overuse, and exploring therapeutic interventions like the Orthopaedic Sleeve to reduce tension on the growth plate are all proactive measures parents can take.
Spotting the Symptoms
- Persistent or recurring heel pain during and after physical activity, continuing into the evening or the following day
- Changes in gait (walking pattern), including limping, toe-walking, or an early heel lift
- Pain localised to the back or underside of the heel, which may intensify upon walking
- Visible signs of inflammation such as swelling, redness, or tenderness at the heel
If these symptoms persist for more than two weeks, a healthcare professional should be consulted promptly. If left untreated, Sever's Disease can be debilitating and impact your child's growth and quality of life.
Treating and Rehabilitating Sever's Disease
Effective management of Sever's Disease is fundamental to ensuring a safe and full recovery for your child. Initial treatment typically involves a period of rest and activity reduction to offload the heel. However, rest alone is not a comprehensive treatment — short bouts of complete rest followed by an abrupt return to exercise will likely result in recurrence.
Crutches, taping strategies, heel lifts, and custom orthotics can be beneficial as they offer a mechanical way to rest and offload the growth plate. Incorporating manual therapy and progressive strength exercises targeting the Achilles tendon is crucial for expedited recovery.
The Role of the Orthopaedic Sleeve
The Orthopaedic Sleeve should be introduced gradually: begin with 1–2 hours on the first day, increasing by an hour per day. It works by offloading the growth plate via its patented design, reducing the tension of the Achilles tendon and plantar fascia on the apophysis — allowing earlier restoration of function and a quicker recovery. As with any treatment, always consult with a healthcare professional.
From Pain to Performance — The Orthopaedic Sleeve Society (TOSS)