Severs Disease

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.