Severs Heel Treatment Birmingham

Severs Heel

Introduction

Severs disease or severs heel as we prefer to call it as the word disease brings up certain connotations in one's mind is also known as calcaneal apophysitis. This condition can occur in young boys and girls. The condition involves the growth plate of the heel, the technical term for this growth plate is epiphyseal plate. This can affect children who are going through the growth spurt between the ages of 8 to 13 for girls and 10 to 15 for boys.

Causes

During early puberty the heel bone can grow at a faster rate than other muscles and tendons in the foot and leg. This can cause these muscles and tendons to be tight which puts more pressure on the growth plate of the heel bone. One of the main tendons that can be tight is the Achilles tendon which attaches to the back of the heel bone. Excessive load on this tendon from jumping, running, hoping can cause damage to the growth plate which can lead to swelling and tenderness in the heel. Sports such as football, gymnastics and running can commonly be associated with this condition.

Contributing Factors

Poorly fitting shoes
Excessive moments of pronation (rolling over of the ankles)
high or low arch of the foot
Overweight

Symptoms

The child will complain of pain in the heel in one or both feet (usually at the back of the heel) which may extend forward to the arch of the foot. The child may have swelling and redness in the heel (this is not always present), discomfort when walking especially when first waking up. He/ she may walk on the tip toes to try and avoid putting weight on the heel.

Treatment

The goal of the treatment is reduce pressure on the heel so that pain is reduced. With the right care this condition can resolve within a few months, rest is very important to reduce the impact forces to the heel. This is very difficult with active children but rest from sporting activities will really help. Visit our podiatry clinic for an assessment to check which associated structures are tight so that a progressive rehabilitation and stretching programme can be given. We may recommend special orthotics/ insoles with extra shock absorbing padding in the heel to off load the pressure on the heels for school shoes. Specially designed gel heel pads may be given for slippers which need to be worn indoors. We usually recommend that the child does not walk or run barefooted without these gel heel pads and slippers at all times for a few months and then slowly return back to full sporting activities. Other factors such as the child being overweight needs to be addressed to reduce pressures on the heels.