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Ashland / Mansfield Foot & Ankle Specialists
45 Amberwood Parkway Ashland, OH 44805(419) 281-3668
550 S Trimble Rd Mansfield, OH 44906-3418(419) 756-1961
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Calcaneal Apophysitis (Sever's Disease)

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What Is Calcaneal Apophysitis?
Calcaneal apophysitis is a painful inflammation of the heel’s growth plate. It typically affects children between the ages of 8 and 14 years old, because the heel bone (calcaneus) is not fully developed until at least age 14. Until then, new bone is forming at the growth plate (physis), a weak area located at the back of the heel. When there is too much repetitive stress on the growth plate, inflammation can develop.

 

Calcaneal278Calcaneal apophysitis is also called Sever’s disease, although it is not a true “disease.” It is the most common cause of heel pain in children, and can occur in one or both feet.

Heel pain in children differs from the most common type of heel pain experienced by adults. While heel pain in adults usually subsides after a period of walking, pediatric heel pain generally doesn’t improve in this manner. In fact, walking typically makes the pain worse.

Causes
Overuse and stress on the heel bone through participation in sports is a major cause of calcaneal apophysitis. The heel’s growth plate is sensitive to repeated running and pounding on hard surfaces, resulting in muscle strain and inflamed tissue. For this reason, children and adolescents involved in soccer, track, or basketball are especially vulnerable.

Other potential causes of calcaneal apophysitis include obesity, a tight Achilles tendon, and biomechanical problems such as flatfoot or a high-arched foot.

Symptoms
Symptoms of calcaneal apophysitis may include:

  • Pain in the back or bottom of the heel
  • Limping
  • Walking on toes
  • Difficulty running, jumping, or participating in usual activities or sports
  • Pain when the sides of the heel are squeezed

Diagnosis
To diagnose the cause of the child’s heel pain and rule out other more serious conditions, the foot and ankle surgeon obtains a thorough medical history and asks questions about recent activities. The surgeon will also examine the child’s foot and leg. X-rays are often used to evaluate the condition. Other advanced imaging studies and laboratory tests may also be ordered.

Treatment
The surgeon may select one or more of the following options to treat calcaneal apophysitis:

  • Reduce activity. The child needs to reduce or stop any activity that causes pain.
  • Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.
  • Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue.
  • Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile.

Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.

Can Calcaneal Apophysitis Be Prevented?
The chances of a child developing heel pain can be reduced by:

  • Avoiding obesity
  • Choosing well-constructed, supportive shoes that are appropriate for the child’s activity
  • Avoiding or limiting wearing of cleated athletic shoes
  • Avoiding activity beyond a child’s ability.

Learn More

  • Bunions
  • Diabetic Care
  • Heel Pain
  • Arterial Doppler

Patient Education

Patient Education
  • Posterior Tibial Tendon Dysfunction (PTTD)
  • Accessory Navicular Syndrome
  • Common Disorders of the Achilles Tendon
  • Achilles Tendon Rupture
  • Diabetic Complications and Amputation Prevention
  • Ankle Arthritis
  • Ankle Fractures
  • Chronic Ankle Instability
  • Ankle Pain
  • Ankle Sprain
  • Arch Pain
  • Arch Supports
  • Athlete's Foot
  • Baseball Injuries to the Foot and Ankle
  • Basketball Injuries to the Foot and Ankle
  • Soft Tissue Biopsy
  • Black Toenails
  • Bone Healing
  • Bone Infection
  • Bone Tumors in the Foot
  • Brachymetararsia
  • Bunions (Hallux Abducto Valgus)
  • Bursitis
  • Calcaneal Apophysitis (Sever's Disease)
  • Fractures of the Calcaneus (Heel Bone Fractures)
  • Calf Pain
  • Callus
  • Capsulitis of the Second Toe
  • Cavus Foot (High-Arched Foot)
  • Charcot Foot
  • Clubfoot
  • Cold Feet
  • Compartment Syndrome
  • Contact Dermatitis
  • Corns
  • Cracked Heels
  • Crutch Use
  • Custom Orthotic Devices
  • Cyst-Ganglion
  • Deep Vein Thrombosis (DVT)
  • Dermatitis
  • Diabetic Complications and Amputation Prevention
  • Diabetic Foot Care Guidelines
  • Diabetic Peripheral Neuropathy
  • Diabetic Shoes
  • Drop Foot
  • Dry Heels
  • DVT (Deep Vein Thrombosis)
  • Eczema of the Foot
  • Equinus
  • Extra Bones
  • Fallen Arches
  • Field Hockey Injuries to the Foot and Ankle
  • Fifth Metatarsal Fracture
  • Flatfoot-Adult Acquired
  • Flatfoot-Flexible
  • Flatfoot-Pediatric
  • Flexible Flatfoot
  • Foot Arthritis
  • Foot Bumps
  • Foot Drop
  • Foot Fracture
  • Foot Lumps
  • Foot Odor
  • Foot Rash
  • Football Injuries to the Foot and Ankle
  • Fracture-Ankle
  • Fracture-Foot
  • Fractures of the Calcaneus (Heel Bone Fractures)
  • Fractures of the Fifth Metatarsal
  • Fracture-Toe
  • Frostbite
  • Fungal Nails
  • Ganglion Cyst
  • Gangrene
  • Golf Injuries to the Foot and Ankle
  • Gout
  • Haglund's Deformity
  • Hallux Rigidus
  • Hammertoes
  • Heel Bone Fractures
  • Heel Cracks
  • Heel Fissures
  • Heel Pain (Plantar Fasciitis)
  • High-Arched Foot
  • Inflammation: Actue
  • Ingrown Toenails
  • Instructions for Using Crutches
  • Intermetatarsal Neuroma
  • Intoeing
  • Joint Pain in the Foot
  • Joint Swelling in the Foot
  • Jones Fracture
  • Lacrosse Injuries to the Foot and Ankle
  • Lisfranc Injuries
  • Lumps
  • Malignant Melanoma of the Foot
  • MRSA Infection of the Foot
  • Orthotics
  • Os Trigonum Syndrome
  • Osteoporosis
  • Osteoarthritis of the Foot and Ankle
  • Osteomyelitis (Bone Infection)
  • Osteopenia
  • P.A.D. (Peripheral Arterial Disease)
  • Pediatric Flatfoot
  • Peripheral Arterial Disease (P.A.D.)
  • Peripheral Neuropathy: Diabetic
  • Peroneal Tendon Injuries
  • Pigeon-toes
  • Plantar Fasciitis
  • Plantar Fibroma
  • Plantar Wart (Verruca Plantaris)
  • Posterior Tibial Tendon Dysfunction (PTTD)
  • Pump Bump (Hallux Rigidus)
  • Puncture Wounds
  • Rash
  • Raynauds Phenomenon
  • Restless Legs
  • Rheumatoid Arthritis in the Foot and Ankle
  • R.I.C.E Protocol
  • Rugby Injuries to the Foot and Ankle
  • Running and Track Injuries to the Foot and Ankle
  • Running Injuries
  • Sesamoid Injuries in the Foot
  • Shin Splints
  • Shoe Inserts
  • Skin Cancer of the Foot and Ankle
  • Smelly Feet
  • Soccer Injuries to the Foot and Ankle
  • Soft Tissue Biopsy
  • Softball Injuries to the Foot and Ankle
  • Sports Injuries to the Foot and Ankle
  • Staph Infections of the Foot
  • Stress Fracture in the Foot
  • Sweaty Feet
  • Swollen Ankles
  • Swollen Feet
  • Synovitis
  • Tailor's Bunion
  • Talar Dome Lesion
  • Tarsal Coalition
  • Tarsal Tunnel Syndrome
  • Tennis Injuries to the Foot and Ankle
  • Thick Toenails
  • Tingly Feet
  • Tired Feet
  • Toe and Metatarsal Fractures (Broken Toes)
  • Toe Walking
  • Turf Toe
  • Ulcers/Wounds
  • Varicose Veins
  • Volleyball Injuries to the Foot and Ankle
  • Warts
  • Weak Ankles
  • Webbed Toes
  • White Toenails
  • Wounds/Ulcers
  • Wounds-Puncture
  • Yellow Toenails

Our Location

Ashland Office

45 Amberwood Parkway
Ashland, OH 44805
419-281-3668


Mansfield Office 

550 South Trimble Road
Mansfield, OH 44906
419-756-1961

Our Locations

Podiatrist - Mansfield, Ashland Mansfield Foot & Ankle Specialist, 550 South Trimble Road, Mansfield OH, 44906 419-756-1961

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