Sever’s Disease – a common cause of heel pain among sport-active children

Abstract

Objectives: Sever’s disease (Calcaneal Apophysitis) is the most common cause of heel pain in growing and active children and adolescents. Studies imply that the prevalence is increasing for children attending sports with repetitive running and jumping. These children are advised to pause their sport when heel pain occurs. However, activity modifications, immobilization, or absolute rest often has a negative impact and can lead to total drop-out.  The objective of the study is to examine whether an intervention based on information and custom-made insoles can decrease pain levels in children between 6-14 years with Sever’s disease and make them return faster to sport activities instead of the conservative treatment with rest and/or activity modification. Methods: The study is a descriptive observational study based on a database from a physiotherapeutic clinical practice. This included 469 children between 6-14 years with diagnosed Sever’s disease who sought an expert in sports physiotherapy due to severe pain and limited sport activity. Baseline information was collected by the physiotherapist. Parents filled a questionnaire as follow up 3 months after the intervention. Results: The children experienced pain for 10,4 months on average. They all reported that their sport activities had been reduced or stopped entirely due to heel pain. All children received an intervention which included information about Sever’s disease and the physiology of the foot, combined with a customized insole that suspend the heel to relieve pressure on the apophysis of the calcaneus. The intervention helped most of the children to resume their sport activity. Conclusion: Sever’s disease is a painful, discomforting condition which causes reduced activity level in sport-active children and even ceasing sports completely, but customized insoles can ease pain and avert or limit immobilization.