Severs Disease Question...

Question:

I have a 12 year old son who 2 years ago tore his achilles when he fell off his bike. His heel has never been the same since but 8 weeks ago when playing football he tackled a player and his heel was so painful he could not walk on it at all. The following day we went to the hospital and had an x-ray which showed sclerosis. After a week on crutches he was then put in a cast for 6 weeks as the doctor thinks it is severs. The cast was removed but as he was in pain still he is now wearing a boot but still can not put any weight on the heel pad at all. It has now been 8 weeks and has been on painkillers all this time. Does this sound like severs?

Answer:

The short answer is, generally, No, however, Sever's is still a possible cause among other complaints. Please let me clarify this...

Sever's Disease can be very debilitating for young active children. Normally, Sever's disease will settle down very quickly with rest. You cannot provide a better way to rest the heel than with a plaster cast. Knowing this has been performed and the pain still persists would concern me enough to warrant further investigation.

Severs disease is also generally gradual in its onset. You mentioned your son started having real problems after tackling a player. This suggests to me that there may be some other injury present, possibly in conjuction with Sever's disease. This may inclde damage to the achilles tendon, especially if your son is still unable to get the heel to the ground. See your Doctor and request further investigations/scans be performed to find out what other problems are present.

In summary, I find prescription orthotics, heel pads, appropriate footwear and correct exercises alleviate the pain of Sever's disease normally within two to four weeks in 90% of cases. The other 10% of cases may require two to four weeks rest from their chosen sport. In my 20 years of practice I have never needed to use a cast to settle down Sever's disease alone. This is why I believe something else is contributing to your son's continued pain. See your Doctor or Podiatrist for further investigation.