- A common cause of heel pain due to overuse of the calcaneal apophysis in a growing child.
- Classically seen in immature athletes.
- Patients typically complain of activity related pain at the calcaneal apophysis +/- inflammation.
- Examination may reveal a tight achilles tendon with pain to direct palpation over the calcaneal apophysis.
- Severs disease is a clinical diagnosis. Diagnostics are not required prior to treatment or referral.
Initial management is symptomatic:
- Avoid precipitating activities.
- Regular Achilles tendon stretching.
- Apply ice before and after sport.
- Short course NSAIDs.
- Heel pad.
- Formal physiotherapy.
- Diagnostic uncertainty.
- Failure of minimum 3/12 conservative measures.
- Referral for physiotherapy / orthotics.