The most common cause of heel pain in children
Sever’s Disease is a very common problem at the back of the heel bone in children. At the back of the heel bone in children is a growth plate at which growth in the bone occurs at. The growth plate is separated from the rest of the heel by an area of cartilage. Severs disease (or calcaneal apophysitis) is an overuse injury to that cartilage growth area.
The main cause of this problem is simple overuse. This is typically related to higher levels of activity, especially on hard sports surfaces. Children who are overweight will also place more load on this growth plate. The typical symptoms of Sever’s disease is pain on activity at the back of the heel bone. Usually it is more painful when you squeeze the bone from the sides.
The typical approach to treating Sever’s is to reduce the load by decreasing the activity levels of the child and using a soft heel raise to protect the area. After activity they can apply ice to reduce the symptoms. Generally that does deal with most cases. Sometimes is can be difficult to reduce the child activity and they still run around at school when they probably should be resting more. Innovative strategies may be needed to convince them to take it easy. If none of that is helping, more drastic measure such as a plaster cast immobilization may be needed. If nothing else works all that can be done is managing the symptoms until it goes away. The condition is always self-limiting as the growth area merges with the rest of the bone by the early to mid-teens, so it is not possible for the condition to be a problem anymore. Just because it is self-limiting like this does not mean that it should not be treated as it does affect quality of life.
This chat from PodChatLive on calcaneal apophysitis covers all the issues: