What Are The Chief Causes Of Calcaneal Apophysitis?


It is thought to be a traction injury, where the Achilles tendon and Plantar fascia pull in opposite directions. Sever?s occurs in children aged 8 to 16 years old. In children, the heel bone is made up of 2 bones, with a growth plate of cartilage in between the sections, holding these 2 bones together. As the cartilage expands, the edges of it eventually turn to bone, and finally the gap closes. This usually occurs within the first 13-15 years of life. However, because these bones are connected by cartilage they are weaker than normal bones. This is why they are very vulnerable to injury.


Heel pain is very common in children due to the fact they are cnstantly growing. In most children, the heel bone (the calcaneus) is not fully developed until the age of 14 or older. Until then, new bone is forming at the growth plate of the foot (the apophysis, located at the back of the heel), an area which is softer than others due to its role in accommodating the growth. Repetitive stress on the growth plate due to walking, running and sports causes inflammation in the heel area. Because the heel’s growth plate is sensitive, repeated running and pounding on hard surfaces can result in pediatric heel pain. Children and adolescents who take part in a lot of sport are especially vulnerable. Over-pronation (fallen arches and rolling inwards of the feet) will increase the impact on the growth plate and is therefore a significant cause and a major contributing factor to heel pain in children.


The most common symptoms of Sever?s involves pain or tenderness in one or both heels. This pain usually occurs at the back of the heel, but can also extend to the sides and bottom of the heel. A child with Sever?s may also have these common problems, Heel pain with limping, especially after running. Difficulty walking, Discomfort or stiffness in the feet upon awaking. Swelling and redness in the heel, Symptoms are usually worse during or after activity and get better with rest.


Sever?s disease can be diagnosed based on the symptoms your child has. Your child?s doctor will conduct a physical examination by squeezing different parts of your child?s foot to see if they cause any pain. An X-ray may be used to rule out other problems, such as a broken bone or fracture.

Non Surgical Treatment

Podiatrists have an important role in the provision of orthotics to young sufferers of Severs? disease. Orthotics are specialised insoles designed to accommodate problems with the foot. In this particular condition?s case, orthotics are an effective way of making sure that the heel is cushioned in such a way as to reduce a child?s discomfort and alleviate some of the pressure of walking, thereby facilitating the recovery process. Young athletes can benefit from a visit to a podiatrist to learn about prevention and to have orthotics fitted to prevent Severs? disease from developing. Regular stretching to keep joints supple and loose are a great preventative measure, as is making sure that appropriately fitted and supportive shoes (often equipped with orthotics) are used to prevent future injury.