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What Is Sever's Disease (Calcaneal Apophysitis)?  

Calcaneal apophysitis is a painful inflammation of the heel’s growth plate. It typically affects children between the ages of 8 and 14 years old, because the heel bone (calcaneus) is not fully developed until at least age 14. Until then, new bone is forming at the growth plate (physis), a weak area located at the back of the heel. When there is too much repetitive stress on the growth plate, inflammation can develop.

Calcaneal apophysitis is also called Sever’s disease, although it is not a true disease. It is the most common cause of heel pain in children, and it can occur in one or both feet. Heel pain in children differs from the most common type of heel pain experienced by adults. While heel pain in adults usually subsides after a period of walking, pediatric heel pain generally doesn’t improve in this manner. In fact, walking typically makes the pain worse.

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Causes

Overuse and stress on the heel bone through participation in sports are a major

cause of calcaneal apophysitis. The heel’s growth plate is sensitive to repeated

running and pounding on hard surfaces, resulting in muscle strain and inflamed

tissue. For this reason, children and adolescents involved in soccer, track or

basketball are especially vulnerable. Other potential causes of calcaneal

apophysitis include obesity, a tight Achilles tendon and biomechanical problems,

such as flatfoot or a high-arched foot.

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Symptoms

Symptoms of calcaneal apophysitis may include:

•         Pain in the back or bottom of the heel

•         Limping

•         Walking on toes

•         Difficulty running, jumping or participating in usual activities or sports

•         Pain when the sides of the heel are squeezed

•         Tiredness

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