Sever's disease, or calcaneal apophysitis, is a condition characterized by inflammation of the achilles tendon at its point of attachment on the calcaneus, or heel bone. This disease strikes adolescents that participate in sports requiring repetitive actions such as running or jumping.
The Achilles Tendon
According to Gillian Leiberman M.D., the achilles tendon is the largest tendon of the body. Formed by the amalgamation of the gastrocnemius and soleus muscles; the achilles tendon attaches onto the bottom of the calcaneus, or heel bone. When active, the achilles tendon pulls the foot downward; therefore, pointing the toes, also known as plantarflexing the foot.
Cause
Like many bones of the body, during adolescence the calcaneus, or heel bone, is still developing; therefore, it contains a region called the apophysis, which is a cartilaginous plate that provides a zone for bone growth. The apophysis is filled with immature cells that are not as durable as bone; therefore, it is prone to injury. With age, the apophysis is replaced by bone. The achilles tendon is the amalgamation of the calf muscles; it attaches onto the calcaneus, in the region of the apophysis. Sports activities that require running or jumping increase the pulling force of the achilles tendon upon on the immature apophyseal plate, causing inflammation, swelling and heel pain, according to the Children's Hospital of Philadelphia.
Signs and Symptoms
A child will experience heel pain when walking or increased pain during activities that require running or jumping, according to University Sports Medicine.
Exams and Tests
Sever's disease is diagnosed by a physician by applying pressure along the back portion of the bottom of the heel; if Sever's disease is present, this procedure will evoke pain. An x-ray may be order to assess the apophyseal plate for damage, says University Sports Medicine.
Treatment
Sever's disease is treated initially with rest. A heel pad is place under the affected heel, when wearing shoes, to slacken the achilles tendon and decrease the stress placed upon the calcaneus. Calf muscle stretching is recommended, in addition to icing the area to decrease inflammation. The adolescent may return to sports once pain is no longer experienced during the activity. If the child is returned to activity too soon, the injury could remain and cause permanent damage, according to Harvard University and the Massachusetts General Hospital.
Prevention
To prevent Sever's disease a child should wear properly fitted shoes, with enough heel padding to provide shock absorption. Extra heel padding can be added to a shoe during high impact sports, according to University Sports Medicine.
