What is Sever's Syndrome?

Sever's Syndrome, also known as Sever's disease, is primarily a childhood condition, affecting children between the ages of 8 and 14 who are undergoing rapid growth during early puberty. The syndrome is attributed to inflammation of the growth plate in the heel. During these growth spurts, the leg bones may outpace the muscles and tendons in growth, leading to tension in the heel's growth plates. This tension manifests as symptoms such as pain, tenderness, and swelling in the heel, which tend to worsen with physical activities, particularly those involving running and jumping. The pain typically eases with rest.

Diagnosis of Sever's Syndrome is generally made through a combination of medical history and physical examination, with imaging tests used occasionally to exclude other conditions. Factors increasing the risk of this condition include active participation in sports, a recent growth spurt, and, in some cases, overweight and obesity due to the added stress on the heel.

Major Causes of Sever's Syndrome

• Growth plate inflammation on the back and the bottom of heel in children between 8 and 14.years of age
• Seen in active children who often go barefoot
• Poor foot posture such as low arch or extremely high arch feet causes overload of the heel
• May occur during growth spurts

Signs and Symptoms of Sever's Syndrome

No evidence of redness or swelling

Unlike many other inflammatory conditions, Sever's Syndrome may not always present with visible signs of inflammation such as redness or swelling around the heel area. This can sometimes make it harder to identify just by observation

Usually associated with tight lower extremity muscles

Children with Sever's Syndrome often have tight muscles in their lower extremities, particularly the calf muscles. This tightness can contribute to the strain on the heel and exacerbate the condition

Tenderness to press the area of the growth plate

One of the most telltale symptoms is tenderness or pain when pressure is applied directly to the growth plate area on the heel. This is often a key indicator used in diagnosing the condition.

Pain to the heel bone at the end of an activity

Pain in the heel bone, particularly noticeable at the end of physical activities like sports or exercise, is a common symptom. The pain usually subsides with rest

Occasionally painful to the Achilles tendon

There may be occasional pain in the Achilles tendon, as it attaches to the area near the growth plate of the heel. This pain can be due to the increased tension and stress on the tendon

Stiffness after sitting and getting up to walk

Children with Sever's Syndrome might experience stiffness in the heel area after sitting for a period and then standing up to walk. This stiffness usually eases as they continue to move

Limping after sitting and getting up to walk

Limping is often observed, especially after getting up from a seated position following sports or exercise activities. This is due to the pain and stiffness in the heel, which temporarily affects normal walking

Sever's Syndrome Treatment

• Custom molded prescription orthotics (shoe inserts) to support poor foot posture(low arch or high arch feet)
• Heel lifts in the early stages of treatment to help decrease the pull of the tight calf muscle and Achilles tendon
• Stretching exercises to help stretch the tight calf muscles
• Physical Therapy Modalities to help reduce the inflammation
• Night splinting to prevent tightness or low grade spasm of the calf muscles while sleeping
• Give enough rest to reduce heel pain, allowing the inflamed growth plate to heal
• Additionally, applying ice to the affected heel for 15-20 minutes several times a day can help reduce inflammation and alleviate pain.