The symptoms of Sever’s disease consist of a gradual onset of heel pain where the Achilles tendon inserts into the bone, occasionally associated with localized swelling. This is associated with local tenderness to palpation over the heel bone. It is quite often found on both sides. It is commonly found in adolescent’s ages 10-15 and often related to participation in sports involving running, cutting and jumping.
The cause of this inflammatory condition is associated with periods of significant growth resulting in the muscle and tendon tissue being tight and creating tension at their attachment point to the bone. These growth changes in conjunction with increased volume or intensity of running, cutting and training will lead to this painful condition. Poor foot biomechanics and poor proximal core and hip motor control can also contribute to this condition. These growth changes in conjunction with poor mechanics and increased volume or intensity of running, cutting and training can lead to this painful condition.
Relative rest and activity modification, followed by a gradual return to sporting activity is usually indicated. Occasionally a 1-2 week bout of immobilization is indicated in severe cases. Regular use of ice post activity assists in controlling inflammation as return to full activity is ramped up. Calf flexibility exercises and deep tissue mobilization is important to relieve muscle tightness. Motor control exercises and shoe inserts/orthotics are both very useful in correcting poor mechanics.