Sever's Condition

Picture of the metatarsal (foot) and calcaneus (heel) bones, the plantar fascia ligament, and the Achilles tendon of the lower leg and foot

Sever's condition is an inflammation of the growth plate of the bone at the back of the heel (apophysitis of the calcaneus). The inflammation of Sever's condition is at the point where the Achilles tendon attaches to the back of the heel bone.

Sever's condition is caused by sprain injury where the Achilles tendon attaches to the calcaneus bone at the back of the heel.

• Sever's condition occurs in adolescent or older children, particularly active boys.
• It can be very painful.
• It is one of those conditions commonly referred to as "growing pains."
• Patients are evaluated for signs of conditions that can mimic Sever's condition, such as ankylosing spondylitis and other forms of arthritis.
• Usually, Sever's condition is self-limited; that is, it disappears as the child ages.

• Sever's condition causes pain at the back of the heel.
• The pain is increased with plantar flexion of the ankle (pushing down with the foot as if stepping on the gas), particularly against resistance.
• Sever's condition also causes tenderness and swelling in the area of the pain.

Sever's condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.

When the condition flares, it is treated

• with activity limitation,
• medication to reduce inflammation (such as ibuprofen [Advil] or naproxen [Aleve]),
• shoe inserts,
• heel lifts,
• cold packs, and
• sometimes casting when it becomes especially severe.

Sever's condition is generally a self-limited problem that usually improves within a year.