Your child has been referred to the clinic because of his/her heel pain. Examination and X-rays have shown no serious disease. The pain is due to a condition called "Sever's Disease". This leaflet tells you about Sever's Disease.
WHAT IS SEVER'S DISEASE?
It is not really a disease at all. It is a type of growing pain, which protects your child's growing skeleton from damage caused by over activity at a time when rapid growth of the heel bone makes the bone weaker than normal.
SO WHAT CAUSES THE PAIN?
At the back of a child's heel there is a thin slice of bone that is separated from the rest of the heel bone by a growth plate. A growth plate is made from gristle and is weaker than bone. Attached to one end of this slice of bone is the Achilles' tendon and calf muscle. At the other end is the strong ligament that supports the long arch of the foot. When a child is growing fast the growth plate becomes thicker and even weaker. The thin slice of bone, particularly in a very active child, is pulled so hard between the Achilles' tendon and the arch ligament that it develops tiny crack fractures. These fractures are painful but the pain is important. It stops your child from pulling off the tendon, which would leave him/her disabled. Adults cannot get Sever's disease because we don't have growth plates.
HOW IS IT TREATED?
The most important thing is to reduce your child's level of sport to the point where the heel pain is only minor. Once the bone is no longer being torn in two by excessive activity the crack fractures heal. It is then usually possible to again increase activity. However, because the growth plate remains weak during rapid growth the problem can recur. If it does, you will have to reduce their sport till things once more improve. This usually happens when growth slows again, since growing occurs in spurts.
WHY AREN'T THE FRACTURES TREATED WITH PLASTER?
They can be. However plasters are uncomfortable, weaken the bones and make the joints stiff. The crack fractures will heal just as well without a plaster. There is then less risk that the problem will immediately recur because the child thinks the plaster has cured them and again runs around wild.
CAN ANYTHING ELSE BE DONE TO HELP?
Yes. Sometimes the calf muscles tighten up because they grow more slowly than the bones. Tight muscles will pull harder on the heel bone through the Achilles' tendon and make the pain worse. Exercises to stretch out the calf muscle may therefore help the pain. Wearing trainers or shoes with a bit of a heel may also help. The reason ladies wear high heels is that the calf muscle works less hard which makes it slimmer (and thus more attractive!). If the muscle pulls less hard, the pain should also be less.