Understanding Sever’s Disease in Young Athletes: Causes, Symptoms, and How to Manage It

As young athletes grow and push their bodies to achieve peak performance, they are often prone to certain injuries. One of the most common, but often misunderstood, injuries in young athletes is Sever’s Disease. While it may sound like a serious condition, it is typically manageable with the right approach. Let’s dive into what Sever’s disease is, how it happens, and what you can do to help prevent and treat it.

What is Sever’s Disease?

Sever’s Disease is an overuse injury that affects the heel of growing children and adolescents. Officially known as calcaneal apophysitis, it occurs when the growth plate in the heel becomes irritated or inflamed. The growth plate, or apophysis, is the area where the bone grows, and during periods of rapid growth, it can become particularly vulnerable to stress and strain from physical activity.

The condition is most common in children between the ages of 8 and 14, particularly those who are involved in sports that require running, jumping, or sudden changes of direction—sports like soccer, basketball, and track and field.

How Does Sever’s Disease Occur?

Sever’s disease happens when the repetitive stress placed on the growing heel bone exceeds the ability of the developing tissues to keep up. The Achilles tendon, which connects the calf muscles to the heel, pulls on the growth plate during activities like running or jumping. This repetitive tugging and pressure on the growth plate leads to inflammation and pain.

It’s important to understand that Sever’s disease is more common during growth spurts, when a child’s bones grow rapidly, and the tendons and muscles may not be able to keep up in terms of flexibility and strength. This imbalance increases the risk of irritation at the growth plate.

How Does Sever’s Disease Present?

The primary symptom of Sever’s disease is heel pain, especially after physical activity. Here’s what you may notice:

• Pain in the back or bottom of the heel: This pain may worsen with running, jumping, or walking long distances.

• Tenderness when pressure is applied to the heel: The heel may feel sore when touched, especially near the Achilles tendon insertion.

• Swelling or redness: In some cases, mild swelling may occur at the heel.

• Limping or altered gait: The pain may cause the athlete to change their walking or running pattern, favoring the affected leg.

• Pain that gets worse over time: Initially, the pain may be mild and occur after sports activity, but if left unaddressed, it can intensify and become more frequent.

What Does Sever’s Disease Mean for Your Young Athlete?

While Sever’s disease is a temporary condition and typically resolves once the growth plates close (usually after puberty), it can be disruptive to an athlete’s training and performance. If untreated or ignored, it could lead to chronic pain, decreased participation in sports, or even other injuries due to compensatory movements.

For parents, coaches, and young athletes, understanding that Sever’s disease is common and manageable is key to minimizing its impact. Rest and proper management can ensure the athlete returns to their sport stronger and injury-free.

Mitigation Strategies

If your young athlete has been diagnosed with Sever’s disease, there are several strategies you can implement to reduce symptoms and prevent future flare-ups:

1. Rest and Activity Modification: Encourage your athlete to reduce activities that cause pain, particularly high-impact sports like running and jumping. Cross-training with lower-impact activities (such as swimming or cycling) may be beneficial while they recover.

2. Stretching and Strengthening: Tightness in the Achilles tendon and calf muscles can exacerbate the condition. Implementing a daily stretching routine for the calves, hamstrings, and Achilles tendon can help reduce tension on the heel. Additionally, strengthening the muscles around the ankle and lower leg may help prevent re-injury.

3. Proper Footwear: Make sure your young athlete is wearing supportive, cushioned shoes that are appropriate for their sport. Avoid shoes that are worn out or poorly fitted, as these can put additional strain on the heel.

4. Ice and Anti-Inflammatory Measures: After activity, apply ice to the heel for 15-20 minutes to help reduce inflammation. Over-the-counter anti-inflammatory medications (like ibuprofen) can also help manage pain, but consult with a healthcare provider before giving them to young athletes.

5. Heel Cups or Insoles: Special heel cups or orthotic insoles can be placed in the athlete’s shoes to reduce pressure on the heel and cushion the area during activity.

6. Gradual Return to Activity: Once the pain subsides, it’s important to gradually reintroduce sport-specific activities. Rushing back into high-impact sports too soon could set the healing process back.

When to Contact a Professional

While Sever’s disease often resolves with conservative management, it’s important to contact a healthcare professional if:

• The pain does not improve with rest and self-care measures.

• The athlete is unable to walk or participate in any physical activity due to pain.

• There’s noticeable swelling or redness that doesn’t subside after a few days.

• The heel pain is accompanied by other unusual symptoms, such as numbness or tingling in the foot.

A healthcare provider, such as a pediatrician, sports medicine specialist, or physical therapist, can offer guidance on treatment options and help develop a safe and effective rehabilitation plan.

Conclusion

Sever’s disease is a common, but treatable, condition affecting young athletes. While it can be frustrating for both the athlete and the family, with proper care and management, most children make a full recovery. By focusing on rest, proper footwear, stretching, and strengthening, athletes can prevent future flare-ups and return to their sport stronger and pain-free. Always consult with a professional if you’re concerned about your athlete’s symptoms or recovery process.

Have any questions or need more advice on managing Sever’s disease? Don’t hesitate to reach out to a healthcare provider or sports performance expert!