What is it
Sever’s Disease is a traction apophysitis (inflammation at a growth plate) of the heel bone usually affecting children between the ages of 8-12 however can occur less commonly up until the age of 15 when the growth fuses. In days gone by it was dismissed as a growing pain. It is a self-limiting condition rather than an actual disease, meaning when the growth plate of the heel fuses your child will not experience this type of pain again.
Sever’s Disease is usually caused by either tensile or torsional forces sometimes a combination of both. As the leg bones grow the calf muscle has to play catch up resulting in tightness of the calf muscle. The calf muscle attaches to the bottom of the thigh bone and to the back of the heel bone. Due to the tightness it may constantly pull where it attaches to the heel bone aggravating the growth plate. When the calf muscle becomes tight it may limit the amount of movement available at the ankle, to compensate for this loss of movement the foot may pronate (roll inwards) excessively. As the foot pronates the leg bones internally rotate creating a twisting action which may further aggravate the growth plate.
How orthotics will help
In the child with flat feet orthotics will work by correcting the alignment of the foot particularly the heel bone. The child with flat feet will have a heel that is pointed inwards orthotics will help to straighten the heel bone thereby taking away some of the tension at the calf muscles insertion point. In the child with a more neutral foot posture Sever’s Disease is most likely caused by the foot pronating excessively compensating for the lack of ankle movement brought on by the tightness in the calf muscle. Controlling the amount of pronation that is allowed to occur will reduce excessive internal rotation of the leg and help to prevent irritation of the growth plate.