Severs Disease (calcaneal apophysitis)was first discovered and named by a European doctor back in the early 1900’s. The term ‘disease’ is a rather strong and slightly misleading one to describe this condition however. We prefer to think of it more as a ‘syndrome’.
It is an inflammation inside the growth plate of the heel bone and a common cause of heel pain in growing children especially when approaching puberty.It is particularly known to affect young teenagers who do a lot of sport or who are very active.
The causes of Severs include tight calf muscles, which lead to a tight Achilles tendon. The Achilles tendon connects onto the heel bone, which sits right on an area called the growth plate.When the Achilles tendon is tight, it starts pulling on and moving the growth plate, which can lead to inflammation and pain.
Calf muscles and bones tend to grow and develop at different rates around the age of puberty in children. In turn, this can cause extra strain on the Achilles tendon which, as we’ve said, then affects the growth plate. Generally the condition occurs around the 9 to 11 years age range in some growing children.
This syndrome is also caused when the foot is collapsing in too much and getting a torsional twist on the Achilles tendon.Instead of getting micro-fine tears in the tendon,it twists the growth plate, leading to an internal traction,which again can lead to inflammation and swelling.
Changes in the growth plate
The growth plate is a separation between the bone and the back of the bone, in the heel. It contains cartilage cells,which are effectively underdeveloped bone that is still growing.
The problem heals itself in time, as growth peaks are reached (for girls when they turn about 15 years of age and boys up to about age 17). Around those years, the cartilage cells turn to bone cells and then become one unified bone in the heel. Thus the problem is self-limiting and will eventually pass with time.
Treatment in the meantime will help ease the condition as the growth plate evolves.
Please free to call us on (02) 9199 8754 if you would like to know more or need to discuss your condition with us at the Heel Clinic.