Calcaneal Apophysitis

Sever’s Disease
Calcaneal Apophysistis, also known as Sever’s Disease, is a painful inflammation of the growth plate in the heel bone. When too much repetitive stress is applied on the growth plate, inflammation develops. It typically affects children between the ages of 9-15 years.

Predisposing Factors:
1. Growth spurts
2. Over use/activity level
3. Biomechanical problems (flat/high arches)
4. Repetitive impact sports
5. Tight Achilles tendon

Clinical Presentation:
1. Heel pain which typically increases with activity
2. Running/jumping aggravates the symptoms
3. Limping or walking on toes
4. Pain upon “squeezing” the heel bone

This condition can be treated by conservative measures:
1. Stretching exercises: designed to help loosen the calf muscle which relieves the stress applied to the heel.
2. Icing: cold therapy helps reduce swelling and pain by vasoconstricting (narrowing) the blood vessels which limit the internal bleeding at the injured site. Apply ice pack to area for 10 minutes when experiencing pain.
3. Orthotics: custom devices to help prevent abnormal compensations due to biomechanical abnormalities, helps eliminate the opposing pulls of both the plantar fascia and the Achilles tendon.
4. Proper supportive footwear: supportive shoes with heel cushioning and rigid heel counter can assist in healing the injury.