Severs Disease

Severs disease (or calcaneal apophysitis) is common in kids (my kids had it) and something that I write about often (eg here and here) and participate in lot of discussions about it, so check them out for more detail.

Some issues have come out of all that:

1. We still do not know if the condition is due to the excessive pull of the Achilles tendon or excessive ground impact on the growth plate. It could be one or the other or it could be both. Interestingly, there are some quite strong opinions either way as to which one it is, but in reality, we have no idea which one it is and it could easily be either one or a combination. It could also be different in different individuals.

2. Managing workload or activity levels is key and children are children, and they don’t listen. Sports levels can be reduced, but they still run around at school or when not being supervised. This really came home to me when my own daughter got it. No matter what I did to treat her, I had no control over what running around she would do at school with her friend during the lunch break.

3. There has been a lot of commentary about it being called a “disease”, especially in the context of all the recent discussion of the use of nocebic language when it comes to managing people that are in pain. It is not a disease and probably should not be called one.

4. It’s not totally clear what it is, but I like to pretend that it’s like a stress fracture of the growth plate and treat it as though it is one. It just makes sense to think like that.

My standard treatment is just education about manageing lifestyle and loads while it comes right in its own. A “Severs Disease Heel Pad” is often helpful. That is all most cases need with only a few needed more intervention than that.

My next thing to do on Severs is to update the PodiaPaedia entry.

We did this PodChatLive video on Calcaneal apophysitis with Alicia James: