Severs Disease, otherwise known as Osteochondroses, is the most common injury of its kind to affect children?s feet. The condition predominately affects children between the ages of 8 - 15 and causes
pain at the back of the heel where the Achilles tendon inserts onto the bone. Children will complain of pain during activity and may have difficulty walking.
During the growth spurt of early puberty, the heel bone sometimes grows faster than the leg muscles and tendons. This can cause the muscles and tendons to become very tight and overstretched, making
the heel less flexible and putting pressure on the growth plate. The Achilles tendon is the strongest tendon that attaches to the growth plate in the heel. Over time, repeated stress, from physical
activities and sports, on the Achilles tendon damages the growth plate, causing the swelling, tenderness, and pain of Sever's disease.
The most obvious sign of Sever's disease is pain or tenderness in one or both heels, usually at the back. The pain also might extend to the sides and bottom of the heel, ending near the arch of the
foot. A child also may have these related problems, swelling and redness in the heel, difficulty walking, discomfort or stiffness in the feet upon awaking, discomfort when the heel is squeezed on
both sides, an unusual walk, such as walking with a limp or on tiptoes to avoid putting pressure on the heel. Symptoms are usually worse during or after activity and get better with rest.
A doctor can usually tell that a child has Sever's disease based on the symptoms reported. To confirm the diagnosis, the doctor will probably examine the heels and ask about the child's activity
level and participation in sports. The doctor might also use the squeeze test, squeezing the back part of the heel from both sides at the same time to see if doing so causes pain. The doctor might
also ask the child to stand on tiptoes to see if that position causes pain. Although imaging tests such as X-rays generally are not that helpful in diagnosing Sever's disease, some doctors order them
to rule out other problems, such as fractures. Sever's disease cannot be seen on an X-ray.
Non Surgical Treatment
To help relieve pain, give your child nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen, as directed by your child?s provider. Nonsteroidal anti-inflammatory medicines
(NSAIDs), such as ibuprofen and naproxen, may cause stomach bleeding and other problems. Read the label and take as directed. Unless recommended by your healthcare provider, your child should not
take the medicine for more than 10 days. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby
aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye's syndrome. Ask your child?s healthcare provider, How and when you
will hear your child?s test results. How long it will take for your child to recover. What activities your child should avoid and when your child can return to normal activities. How to take care of
your child at home. What symptoms or problems you should watch for and what to do if your child has them. Make sure you know when your child should come back for a checkup.
For children with Sever's disease, it is important to habitually perform exercises to stretch the hamstrings, calf muscles, and the tendons on the back of the leg. Stretching should be performed 2-3
times a day. Each stretch should be performed for 20 seconds, and both legs should be stretched, even if the pain is only in one heel. Heel cups or an inner shoe heel lifts are often recommended for
patient suffering from Sever's disease. Wearing running shoes with built in heel cups can also decrease the symptoms because they can help soften the impact on the heel when walking, running, or