The calcaneal apophysis is a growth center where the Achilles tendon and the plantar fascia attach to the heel. It first appears in children aged 7 to 8 years. By ages 12 to 14 years the growth
center matures and fuses to the heel bone. Injuries can occur from excessive tension on the Achilles tendon and the plantar fascia, or from direct impact on the heel. Excessive stress on this growth
center can cause irritation of the heel, also called Sever?s disease.
Overuse and stress on the heel bone through participation in sports is a major cause of calcaneal apophysitis. The heel?s growth plate is sensitive to repeated running and pounding on hard surfaces,
resulting in muscle strain and inflamed tissue. For this reason, children and adolescents involved in soccer, track, or basketball are especially vulnerable. Other potential causes of calcaneal
apophysitis include obesity, a tight Achilles tendon, and biomechanical problems such as flatfoot or a high-arched foot.
Sever's disease causes pain and tenderness in the back and bottom of the heel when walking or standing, and the heel is painful when touched. It can occur in one or both feet.
Sever disease is most often diagnosed clinically, and radiographic evaluation is believed to be unnecessary by many physicians, but if a diagnosis of calcaneal apophysitis is made without obtaining
radiographs, a lesion requiring more aggressive treatment could be missed. Foot radiographs are usually normal and the radiologic identification of calcaneal apophysitis without the absence of
clinical information was not reliable.
Non Surgical Treatment
Sever disease is heel pain in children. This pain is caused by inflammation of the heel growth plate. The growth plate is the area where the bone grows. It is located on the lower back part of the
With proper care, your child should feel better within 2 weeks to 2 months. Your child can start playing sports again only when the heel pain is gone. Your doctor will let you know when physical
activity is safe.