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In Response To: "Re: Heel Pain - Calcaneal Apophysitis- Severs Disease Information"
There have been quite a few kids presenting to the office this Spring with heel pain. One of the many possibilities for pain in this area of the foot can be attributed to the growth plate. I hope you find this article I wrote for Back of the Net informative and helpful.

Severs Disease could be the cause of your athletes heel pain.

Severs Disease, also known as Calcaneal Apophysitis, is a painful foot condition that usually affects active children between 8 and 15 years of age, whose heel bones are actively growing. Active children may often suffer from Severs Disease when they experience sharp, aching pain in their feet, particularly in their heels, which may cause them to change the way they walk or run. A child with a pronated foot (flat foot) or a child with increased weight will have a greater predisposition to the condition.

The main symptom associated with Severs Disease (Calcaneal Apophysitis) is localized pain in the heel of the foot (at the bottom, sides or the back of the heel) or where the achilles tendon attaches to the heel bone, or calcaneus. The condition is caused by the gastrocnemius muscle pulling on the attachment point of the Achilles tendon on the calcaneal tuberosity as well as chronic pounding to this growth plate.
This over pulling of the achilles tendon along with increased stress to the growth plate (where the heel grows from), in combination with overuse are the main culprits that triggers this condition.

The injury often is associated with running and jumping activities such as lacrosse, soccer, basketball, and track. However it can occur suddenly in children who do not participate in organized sports. This pain can be especially noticeable when a child walks or runs during any type of sporting or physical activity. Placing pressure on the area may also be extremely painful, particularly during jumping and propulsion or walking barefoot.

Initial treatment for Severs Disease should begin with limiting physical activity, as maintaining intense exercise will only cause the pain to worsen. Along with ice, elevation and physical therapy, (Rest, Ice, Compression and Elevation). If symptoms don't resolve and there are no contraindications you may add Motrin or Tylenol as needed.

Unfortunately, many times these treatments alone may prove to be inadequate. The condition, osteochondrosis at the tendon's attachment point on the Calcaneal tuberosity, may include microscopic bone chipping, inflammation and tears, and in the most extreme cases, separation of both cartilage and bone from the bone. Wearing supportive heel cups and shoes is also important in order to help keep as much stress off the heel as possible, however supportive shoes alone will not usually be effective in curing the condition.

Orthotics, custom shoe inserts, are a good way to treat the symptoms, as well as help eliminate Severs Disease completely. Orthotic devices have had great success in treating children who suffer from Severs Disease, in addition to other painful foot ailments. The orthotics will correct improper foot position while the child is weight bearing as well as provide some cushioning. If you have any further questions concerning this article feel free to contact me at the office.

Dr. Steven J. Stummer


2631 Merrick Rd., Ste. 300 Bellmore, N.Y. 11710 (516) 781-9800
220 Fort Salonga Rd. (25A) Northport, N.Y. 11768 (631) 262-8505 , 0
100 Manetto Hill Road, Ste 103 Plainview, N.Y. 11803 (516) 449-1842

Melville Location 631-293-9540
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