Calcaneal Apophysitis, commonly called Sever's Syndrome is a heel injury common to youth. Those affected are often active in sports such as running, basketball and soccer and between the ages of 7 and 15.
Sever's syndrome is a bone injury associated with repetitive microtrauma resulting in inflammation of the growth plate in the heel (the calcaneal apophysis).
Sever's syndrome is self limiting - eventually it will resolve on its own over time. The growth plate in the heel will eventually fully fuse once growing has stopped resulting in relief, but it can take years, making early intervention ideal!
The Problematic Mechanics
1. During periods of rapid growth bones grow faster than the muscles and tendons. As a result, the muscles and tendons have a tendency to become tight. Because the Achilles tendon attaches onto the heel bone the growth plate in the heel is placed under traction due to excess pulling from the Achilles tendon. Tight calf muscles are often see with Sever's Syndrome.
2. Damage from repetitive loading during high impact sports. The heel's growth plate is sensitive to repetitive heel strikes and pounding on hard surfaces, which disturbs the growth plate causing inflammation.
3. Excessive pronation: When the arch of the foot unlocks and collapses it makes the foot a mobile adaptor as opposed to a rigid lever making the calf muscles work harder to lift the heel off the ground increasing the stress on the growth plate.
1. Minimize inflammation and limit pain through ice and rest.
2. Address the biomechanical factors with a foot orthotic with the goal of reducing stress placed on the growth plate: through increasing the surface area in contact with the foot to decrease areas of high pressure at the heel, by taking stress off of the Achilles tendon, and if necessary limiting the degree that the arch of the foot collapses.
3. Stretching designed to increase flexibility and lengthen the calf muscles.