A
young person aged between 10 and 15 suffering with pain and tenderness at the
back of the heel may have Severs Disease. Tenderness will be felt especially if you squeeze
the back of the heel from the sides. Sometimes there may be a lump over the
painful area. Often the pain goes away when taking a rest from sporting
activities, only to return when training is resumed.
Severs disease is a type of apophysitis which occurs in the heel bone.
Children's bones have growth plates from where the bone grows and matures. The
Achilles tendon inserts into the back of the calcaneum, or the 'heel
bone'. Severs disease is often
associated with a rapid growth spurt. As the bones grow, the muscles and
tendons become tighter as they do not grow at the same rate as the bone, the
tendon then pulls on the calcaneum. The point at which the achilles tendon
attaches to the heel becomes inflamed and the bone starts to
crumble. This happens before the calcaneum fuses at the
site of the growth plate after the age of around 15. It can occur in one or
both heels.
Walking on the damaged foot or feet will delay healing and as a result,
rest is very important - stopping any activity which make it worse. Ice wrapped in a tea towel and applied to the
area may help.
Sometimes footwear may be worn down or damaged at the heel, which will
make the condition worse. Replacing this footwear is an excellent start to
relieving the pain.
A podiatrist may suggest a heel pad or heel raise
into the shoes. This has the effect of raising the heel and shortening the calf
muscles and so taking the strain off the back of the heel. Stretching exercises
are very important, they should be performed within pain limits, under the
supervision of a professional.
A full biomechanical examination will help determine if
there are any issues which are contributing to the problem.
