Calcaneal Apophysitis (Sever’s Disease)

As kids grow into adults, their bones have multiple growth plates. One growth plate in the back of the heel tends to be a common problem for many children. Children can inflammation of the growth plate and this causes severe pain. Podiatrist call the growth plate on the back of the heel the “calcaneal apophysis”. When you get inflammation of the calcaneal apophysis it is called calcaneal apophysitis.

Calcaneal apophysitis usually affects kids between the ages of 8 – 14 y/o.  I would say the most common age is 10 y/o. The growth plate on the back of the will eventually incorporate into the rest of the heel bone after age 14.

When your kid is very active or participates in many sports, stresses can be placed on the growth plate and inflammation can occur. The heel’s growth plate is very sensitive to repeated running and pounding on hard surfaces, resulting in strain of the muscles and inflammation. Also, kids that may be a little on the heavy side may be more susceptible. Other things like a tight achilles tendon, flatfeet and high-arched feet can also predispose children to this condition.

Symptoms include the following:

1. Pain in the back or the bottom of the heel

2. Limping

3. Kids will walk on their toes

4. Difficulty participating in sports that require sprinting or jumping

5. Pain with side to side squeeze of the heels

Diagnosis is usually made by clinical evaluation and  x-rays. Sometimes advanced imaging studies like MRI or CT is ordered as well as bloo labs.

Treatment

1. Reduce the child’s activity – if the child has pain with running, the kid should stop running

2. Heel lifts – by placing a temporary wedge under the heel, strain or pull of the achilles is lessened and will reduce the tension on the growth plate on the back of the heel

3. Anti-inflammatory medications – NSAIDS or steroids

4. Physical therapy – sometimes stretching and other physical therapy techniques help significantly

5. Casting – in severe cases of apophysitis, a below-knee cat is applied and the child is advised to be non-weightbearing.

Calcaneal apophysitis can be very difficult to get rid. Oftentimes, the biggest hurdle to cross in healing the heel is making the parents understand that their kid needs to take a break from sports or physical activity. Sometimes, parents have their kids involved in so many activities, the heel and growth plate never has an opportunity to relax and  heal.

If your child has heel pain and you want them to be seen by a specialist, please consult Dr. Kory Williams or Dr. Eric Silvers at Advanced Foot & Ankle Center in McKinney, TX  & Prosper, TX.