View source for Sever's disease

{{Infobox_Disease |
  Name           = Severs |
  Image          = Gray1241.png |
  Caption        = The mucous sheaths of the tendons around the heel. Lateral aspect. (Tendo calcaneus labeled at left.)|
  DiseasesDB     = 11980 |
  ICD10          = |
  ICD9           = |
  ICDO           = |
  OMIM           = |
  MedlinePlus    = |
  eMedicineSubj  = orthoped |
  eMedicineTopic = 622 |
  MeshID         = |
}}
'''Sever's disease or calcaneal apophysitis''', is the most common cause of heel pain in the growing athlete and is due to overuse and repetitive microtrauma of growth plates of the [[calcaneus]] in the heel.  It occurs in children ages 7 to 15, with the majority of patients presenting between 10 and 12 years of age. It is in relation to [[Osgood-Schlatter disease]] which affects the knee rather than the heel/ankle.

==Eponym==
It is named for JW Sever, who characterized it in 1912.<ref>Sever JW: Apophysitis of the Os Calcis. New York Medical Journal 1912; 95: 1025-1029.</ref>

==Symptoms==
*Complaints of pain or tenderness in the [[heel]] (or heels) 
*Discomfort upon awaking, or when heel is squeezed 
*Limping 
*More severe pain after walking or exercise, and increased difficulty walking 
*Pain during running or playing a sport

==Cause==
Sever’s disease is directly related to overuse of the [[bone]] and tendons in the heel. This can come from playing [[sports]] or anything that involves lots of heel movements. It can be associated with starting a new sport, or the start of a new season.<ref name="pmid15555843">{{cite journal |author=Hendrix CL |title=Calcaneal apophysitis (Sever disease) |journal=Clinics in podiatric medicine and surgery |volume=22 |issue=1 |pages=55–62, vi |year=2005 |pmid=15555843 |doi=10.1016/j.cpm.2004.08.011}}</ref> Too much [[weight bearing]] down on the heel can also cause it as can excessive traction since the bones and tendons are still developing.  It occurs more commonly in children who pronate, and involves both heels in more than half of patients.

==Treatment==
Treatment may consist of one or more of the following:
*Elevating the heel
*Stretching hamstring and calf muscles 2-3 times daily 
*Using [[RICE (medicine)|R.I.C.E.]] (Rest, Ice, Compression, Elevation)<ref name="pmid8900359">{{cite journal |author=Madden CC, Mellion MB |title=Sever's disease and other causes of heel pain in adolescents |journal=American family physician |volume=54 |issue=6 |pages=1995–2000 |year=1996 |pmid=8900359 |doi=}}</ref>
*Foot orthotics
*Medication

==Recovery==
Sever’s disease is self-recovering, meaning that it will go away on its own when it is used less or when the bone is through growing. The condition is not expected to create any long-term disability, and expected to subside in 2–8 weeks.<ref name="pmid8900359"> 

However, while the disease does subside quickly, it can recur, for example at the start of a new sports season, several times if it is not taken care of. </ref>

However, while the disease does subside quickly, it can recur, for example at the start of a new sports season. The only known cure is for children to outgrow the condition, and recurrences happen for an average of 18 months before this occurs.

It is more common in boys, although occurs in girls as well. The average age of symptom obset is 9-11.

==Prevention==
*Maintain good flexibility through stretching exercises
*Avoid excessive running on hard surfaces
*Use quality, well-fitting [[shoes]] with firm support and a shock-absorbent [[Sole (shoe)|sole]]

==See also==
* [[List of childhood diseases]]

==References==
<references/>
Micheli and Ireland.  Prevention and Management of Calcaneal Apophysitis in Children: An Overuse Syndrome.  Journal of Pediatric Orthopedics 1987; 7(1): 34-38.

http://www.footphysicians.com/footankleinfo/pediatric-heel-pain.htm

==External links==
*Bibliography: http://www.epodiatry.com/heel-pain-children.htm
*http://familydoctor.org/158.xml
*http://www.footphysicians.com/footankleinfo/pediatric-heel-pain.htm

{{Osteochondropathy}}

{{DEFAULTSORT:Sever's Disease}}
[[Category:Diseases and disorders]]
[[Category:Medical terms]]

[[it:Malattia di Sever]]
[[Category:2Fix]]