Sever's Disease
Sever’s disease is repetitive micro trauma or overuse of the heel in young athletes. Sever’s is caused by overloading the insertion of the Achilles tendon onto the calcaneus and the apophyseal growth plate. Active Children (7 to 15 years), particularly during the pubertal growth spurt or at the beginning of a sport season (e.g. gymnasts, basketball and football players), often suffer from this condition.
Contributing factors to the development of Sever’s disease
There are several factors which may increase the likelihood of developing this condition. These need to be assessed and corrected with direction from a physiotherapist to ensure an optimal outcome. Some of these factors include:
- inappropriate footwear
- calf tightness and/or weakness
- joint stiffness (particularly the foot and ankle)
- poor lower limb biomechanics
- inappropriate or excessive training
- inadequate recovery periods from training or activity
- inappropriate training surfaces
- inadequate warm up
- poor core stability
- a lack of lower limb strength and stability
- poor proprioception or balance
- rapid growth and age
Treatment of Sever’s disease
Consulting with a physiotherapist to confirm the diagnosis is important. Physiotherapist’s will advise on a management plan, usually consisting of activity modification (a reduction in playing and training) and addressing the contributing factors as outlined above. Treatment may include:
- relative rest/modified rest or cessation of sports
- biomechanical correction
- the use of heel wedges
- soft tissue massage
- joint mobilisation
- education
- icing
- taping
- exercises addressing flexibility, strength or balance issues
- footwear assessment and advice
- a gradual return to activity program
Examples of treatment: calf stretches, ice massage protocol
