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Sever Disease/Calcaneal Apophysitis, Sports Medicine

Stephen M. Simons, MD, FACSM and Ryan Sorell, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Sever disease, also known as calcaneal apophysitis, is an overuse syndrome and one of the most common causes of late childhood and adolescent heel pain.

  • This traction apophysitis is t...

DIAGNOSIS

HISTORY

  • An 8- to 13-yr-old child presents with heel pain worsened with increased activity 1[C].

  • Recent growth spurt coincides with vigorous sport or play activities 1[C].

  • Sports requiring a lot...

TREATMENT

  • Rest or reduce activity to a pain tolerance level 2,5[C].

  • Ice 2[C]

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control 2[C]

  • Heel lifts 2,5[C]

  • Shock-absorbing heel inserts 2,5[C]

  • Gastro...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Referral/disposition necessary only when clinician is uncertain of diagnosis 

COMPLICATIONS

Persistent pain that does not respond to conservative measures may indic...

REFERENCES

1
Micheli LJ, Ireland ML. Prevention and management of calcaneal apophysitis in children: an overuse syndrome. J Pediatr Orthop.  1987;7(1):34–38.
2
Hendrix CL. Calcaneal apophysitis (Sev...

ADDITIONAL READING

Tu P. Heel pain: diagnosis and management. Am Fam Physician.  2018;97(2):86–93. 

CLINICAL PEARLS

  • Conservative therapy remains the mainstay of treatment.

  • Diagnosis should be made clinically without radiography unless signs and symptoms are atypical.

  • Total rest may hasten the recovery...

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