(Sever's Disease; Epiphysitis of the Calcaneus)
(See also Overview of Bone Disorders in Children.)
Children's bones grow from soft areas of cartilage near the ends of bones. These areas are called growth plates. When children have finished growing, growth plates become solid bone. After growth plates become solid, bones do not grow in length.
The heel bone develops until about age 15. A child (usually aged 9 to 14) who is athletically active may develop Sever disease if the calf muscle and Achilles tendon excessively pull on their point of attachment to the immature heel bone.
Pain affects the sides or margins of the heel and is aggravated by standing on tip toes or running. Some children have warmth and swelling.
Doctors base the diagnosis on the symptoms. X-rays cannot make the diagnosis of Sever disease but may help identify other causes of heel pain such as bone cysts or stress fractures.
Heel pads relieve pain by reducing the pull of the Achilles tendon on the heel. Splints may be worn at night to stretch the calf muscles, helping maintain flexibility.
In more severe cases, a cast may be recommended to immobilize the area. This treatment relieves pain and stretches the calf muscles. Symptoms of Sever disease may last several months.