Calcaneal Apophysitis/Sever's Disease
What is it: Sever's disease is an injury at the growth plate of the calcaneous.
How does it present: The patient usually presents with heel pain with prolonged standing or activities. The injury usually occurs around the time of a growth spurt, in girls between the ages of eight and ten, and boys ages ten to twelve.
Common exam findings: Decreased heel cord flexibility may be appreciated. Often pain with squeezing the calcaneous is present, or tenderness near the Achilles insertion. The pain can be aggravated by having the patient stand on their toes.
Tests and treatment: Foot x-rays are not always necessary, but may show sclerosis of the calcaneous apophysis. Treatment is generally conservative, such as avoiding aggravating activities, stretching, and consideration of heel cups or pads.