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SEVER'S DISEASE                                                       KANDILNOTES


  • Sever’s Disease, also known as calcaneal apophysitis, is a common condition affecting growing children and adolescents

  • It is characterized by inflammation of the heel bone growth plate

  • This condition is often associated with growth spurts  

  • 100% of Sever’s disease cases resolve by the time of skeletal maturity


  • Sever’s disease is caused by repetitive overload of the achilles tendon on the heel bone growth plate

  • Growth plates are weaker than tendons and ligaments and are more vulnerable to injury

  • Common in active adolescents participating in jumping sports, but can occur in any growing child


  • Pain and occasional swelling in the back of the heel over the achilles tendon and the heel bone

  • Tenderness of the heel bone

  • Pain is usually worse after activity but can also be present at rest


  • Treatment of Sever’s disease is centered around a home exercise program focused on eccentric strengthening and stretching of the achilles tendon

  • Anti-inflammatories such as ibuprofen are oftentimes helpful as an adjunct to other treatments

  • Heel sleeves and heel pads can decrease pain and swelling

  • Heel lifts help offload the achilles tendon

  • In refractory cases, a course of leg casting may be indicated

  • There is no role for surgery in Sever’s disease


  • The best way to prevent this condition is to avoid repetitive activities that overload the achilles tendon

  • Avoid wearing flat shoes in growing children as this may place excessive tension on the achilles and heel bone growth plate

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