After a long weekend of playing multiple soccer games on hard, dry grass, I can distinctly remember walking around like a geriatric man after a workout at Silver Sneakers. I limped around making painful noises and whining about heel pain.
My heels became very sore, felt swollen, and were tender to touch. Although I didn’t know it at the time, I was probably experiencing what’s known as Sever’s disease.
Sever’s disease is a very common cause of heel pain in growing young athletes. It usually occurs around 11½ years of age and is about 3 times more common in boys than in girls.
It occurs during growth spurts because the Achilles tendon in the back of the ankle can’t keep up with the rapid growth of the bones. Since the Achilles tendon attaches to the back of the heel, where the affected growth plate is located, it may act as a tether and pull on the growth plate, causing it to become irritated and inflamed.
During the physical exam to diagnose Sever’s disease, we look for a tight Achilles tendon and pain when putting pressure on both sides of the back of the heel. While the diagnosis is clinical, we also typically order X-rays to rule out other possible causes of heel pain.
So, if you think your young athlete has Sever’s disease, what can you do to help him?
The good news is the pain will go away on its own once the growth plate in the back of the heel begins to close. And it isn’t a dangerous condition so your athlete may continue to play sports as his pain allows.
You may try padded heel cups in shoes to help control symptoms. You may also use anti-inflammatories before competition to decrease inflammation and pain. A stretching program of the Achilles and calf muscle will also help relieve stress off the growth plate and prevent recurrence.
If symptoms recur and your athlete really struggles with heel pain, a short leg cast can occasionally be used for a short period of time.
Although an orthopedic surgeon may make the diagnosis of Sever’s disease, parents are glad to know that there’s no surgery for this. Your young athlete will grow out of it.