Sever's disease is a growth-plate injury that involves the heel. Most people who suffer from this condition, also called calcaneal apophysitis, are active children in the "tween" to early teen years, between the ages of 8 and 15. During a large growth spurt, a child's bones grow faster than the tendons and ligaments that attach muscles to the bones. The heel cord at the back of the foot can tighten, causing pain in the heel, especially during weight-bearing activities. Exercises can help loosen up tight tendons and muscles to ease the pain of Sever's disease.
Stretching Recommendations
Sever's disease may affect only one or both feet at the same time. Even if you do not feel pain in one heel, it is important to stretch both legs at the same time. The stretching can help prevent Sever's symptoms in the other heel, but it also will contribute to an even flexibility and strength between the two sides of your body. Hold each stretch up to 20 seconds if possible and perform the exercises at least twice daily. Wait until the pain has subsided before beginning an exercise routine. Using cold packs and over-the-counter pain relievers can help reduce inflammation.
Stretching Exercises
Stretching the hamstring muscles in the thigh, the calf muscles in the lower leg and the Achilles tendon and heel cord area in the back of the foot can ease the discomfort associated with Sever's disease. Stretching keeps the muscles, tendons and ligaments supple and loose while these soft tissues play "catch up" to a young person's bones during a growth spurt.
Sit on a bench with one leg laid out straight in front of you and the other knee bent with your foot on the floor to stretch out your hamstrings. Lean forward and try to touch your toes; you will feel the stretch in your thigh as you lean. Stand facing a wall to stretch calves and the heel cord. Place one foot a shoulder's width in front of the other, both feet facing the wall. The front knee is bent and the back knee is straight during the calf stretch. Push against the wall and feel the stretch in your back leg. To stretch out the heel cord, stay in the same position and bend the back knee. You should feel a stretch, but no pain, in the back of your foot.
Strengthening Exercises
Shin strengthening can also be performed to relieve the pain of Sever's disease. Resistance bands are required for this exercise; they should be looped around a table leg. Sit on the floor with legs outstretched. Loop the band around the affected foot. Bend the healthy knee and plant the foot on the floor for support. Keeping toes to the sky, curl your foot toward your body as far as you can, thus stretching the band. Stop before you feel pain, and slowly point your foot away from your body. Repeat the full cycle of "toward and away" 15 times.
Resuming Physical Activity
The heel pain that accompanies Sever's disease can be debilitating and may require a full resting period away from sports and physical exercise until the inflammation has decreased. Perform the stretching and strengthening exercises for a week to determine if your symptoms are abating. Symptoms can continue for up to two months in some cases. Children who are sports oriented and enjoy physical play will require patience to limit the chances of a rebound injury. Walking is a good rehabilitative exercise. Alternate each day of walking with a day of rest. Work your way up to a routine of walking for four minutes, jogging for two minutes and repeating the pattern several times daily. After a week of walking and jogging without pain, you may return to your normal workout.
