Common Overuse Injuries in Youth Athletes: Sever’s Disease (series)

What is it: Sever’s disease is also known as calcaneal apophysitis. These two terms might not explain what is going on so I will explain further. This overuse condition happens at the heel where the achilles tendon (calf) and the calcaneous (heel) meet. In children, the growth plate in the area is likely still forming. Repetitive stress such as with running and jumping activities can lead to the growth plate to become inflamed.

Who is most at risk:  The population who is most at risk are active children who are going through their growth spurt ( ages 7-15). This could be at the beginning of the season or when the child has a sudden increase in activity that includes running or jumping. These would include sports including but not limited to basketball, soccer, football, gymnastics, etc. One important risk factor that can be controlled is shoes. A child is most at risk if their footwear are not supportive or worn out when playing sports.

What to look out for: The child would likely have pain in the heel, more towards bottom portion. They may have increased pain/symptoms during the activity and have limp after the activity. Your child may feel better after some rest and first thing in the morning. Lastly, they may have “tightness” in ankle or calf.  ** These alone will not be used to diagnose as there may be numerous other reasons for heel pain**

How to treat or prevent: REST! Rest is going to be the best treatment method if this condition is present in the child. Ice may also help with the pain and symptoms as they recover. This may mean that they take a break from the sport that they are currently playing. Recovery times may vary from child to child and on the severity of the condition. It has been found that it may recover as soon as 2 weeks to 2 months after start of therapy.

 

It has been found that calf tightness may be a contributing factor to getting this condition. Encouraging adequate stretching exercises. Exercises that stretch the calf can allow the stress on the achilles tendon to decrease. Other than stretching, rest throughout the week and between activities may help prevent this condition to develop.

Summary: Sever’s disease is a heel injury that can arise from repetitive jumping and running activities which is a common activity in numerous sports. The child may complain of having heel pain which is increased with the aggravating activity. Understanding the possible injuries that can occur in this age group can help them seek professional guidance in a timely manner. This can lead to improvements in rehabilitation and time off the field.

Stay tuned for more on this series of common overuse injuries in the youth athlete. If you have any questions feel free to drop us a message. Also, subscribe to our page and follow us on Facebook!

Written by: Robert Rojas PT, DPT

References
  1. https://www.physio-pedia.com/Sever%27s_disease
  2. https://orthoinfo.aaos.org/en/diseases–conditions/overuse-injuries-in-children