What is Severs heel pain?
Severs heel pain (calcaneal apophysitis) is a pain in the back or bottom of a child’s heel.
Is occurs at the heel growth plate which is attached to the strong Achilles tendon.
It can range from being mild to absolutely debilitating.
It only occurs in a certain age group, between 8-14 years of age.
So whilst all children will grow out of it eventually, it can affect their enjoyment of life for 18-24 months.
Common causes and risk factors
Common risk factors include:
- activity types and intensities,
- lower limb biomechanics: e.g. very flat feet are more prone to it,
- footwear.
How it affects young athletes' performance and daily life
Some children if untreated can go up to 2 years where they will not be able to play in their chosen sport, and even basic running around with friends is affected.
For others, they will push through it, but they will not be able to perform at their best.
It is not uncommon for children to come off the sporting field crying in pain from severs.
We want all children to get the absolute most out of life, and we see being active as an important part of life, so we work with children and their parents to eradicate heel pain from their lives.
Common in 8 to 14 Year Olds
Calcaneal apophysitis is most common between the ages 8 to 14 and is more common in boys than girls.
Although every child goes through the stage of having an open growth plate in their heel, not every child will develop pain.
Due to its location on the very back of the heel, and with a strong (and often tight) Achilles tendon attaching to it, this growth plate is susceptible to irritation and inflammation.
If this occurs, your child may complain of heel pain, that can worsen with physical activities and can result in them limping.
Signs and Symptoms: Recognizing Severs Heel Pain in Your Child
Pain location and characteristics
Severs pain (calcaneal apophysitis) is usually pretty easy to identify if you know what to look for.
If your child has pain at the back of or under the heel, and they are aged between 8-14, then they are highly likely to have severs.
Whilst there are some other conditions which might cause this pain such as trauma, bruising, foreign objects, or Achilles tendon issues, the most likely culprit will be Severs.
Activities that may exacerbate the pain
The most common activities to exacerbate severs heel pain are:
- all of the football codes, especially soccer and AFL due to the amount of kicking involved.
- any sport where there is repetitive landing on the feet: this could be netball, athletics, tennis or many others,
- sometimes children who aren’t very active will also get severs.
When to seek professional help
If the pain is not resolving within a week or two with simple measures such as icing and rest, then it is time to get some help from a podiatrist.
Podiatrists see severs very regularly and have the knowledge required to get the fastest relief of pain.
Children shouldn’t be in long term (chronic) pain. So get help quickly to avoid pain getting in the way of their enjoyment of life.
Treatment for Severs
Some of the treatment methods effective in reducing pain from Severs are:
- Rest – Getting weight off the heel is the first thing to do.
With athletes we often talk about relative rest. This is where they cut out any weight bearing activities that aren’t as important first. This might be their second or third favourite sports, some training sessions etc.
N.B. Please note that individual professional advice is recommended when choosing the level of activity that is appropriate. - Inserting heel raises into shoes to reduce the tension of the Achilles tendon
- Calf stretches – these need to be done very carefully as they can increase pain in the acute stage.
- Ice applied for 15 minutes after the activity which flares the pain.
- Custom Foot Orthotics – often the fastest way to improve severs pain because they quickly reduce the tension and pressure on the growth plate.
Get Your Child Pain Free
Your podiatrist is best equipped to diagnose calcaneal apophysitis and work out the best treatment plan for you or your child.
With correct treatment someone with Sever’s will be getting back to their favourite activity often within a few weeks.
If you have a child who needs help with their heel pain, call 3351 8878 and let one of our experienced podiatrists get them back to being pain free.
