Servers disease is a condition that occurs in growing children and young teenagers. It is inflammation of the growth plate in the heel also known as the calcaneus. The condition is most commonly caused by repetitive stress to the heel and occurs most often in those who are having a growth spurt. Not only does this condition affect those from a sporting background but also in adolescence, particularly if they are wearing flat shoes a lot of the time. In the majority of cases of severs disease, it will be possible to relieve the pain by simple recovery measures like rest, change in footwear, over the counter medication and strengthening exercise.
Severs diseases is most commonly found in boys who tend to get it between the ages of ten and fifteen whereas girls, as they start puberty earlier, often get the condition between eight and thirteen.
Symptoms may include:
- Swelling or redness on one or both heels
- Pain and tenderness around the back of the heel
- Tightness in the back of the heel that feels worse when squeezed
- Heel pain that gets worse after exercises such as running or jumping and feels better after rest
Servers disease affects the growth in the heel bone known as the calcaneus. This growth area is also an attachment point or the Achilles tendon which connects further up the leg to the calf muscles.
Repetitive overload of running, jumping and changing direction can cause pain and inflammation in this area. Additional stress from soft tissue structure in the area such as tightness in the calf muscles and an overworked Achilles tendon can also contribute to the disease causing more pain and irritation.
Initial treatment for Servers disease focuses on reducing pain and swelling within the growth plate area to reduce irritation. Normally this requires limiting exercise and activity to allow the area to heal correctly and until your child can complete day to day activities without any form of pain or post exercise soreness. In some cases, this has to be for several months followed by a rehabilitation programme to strengthen your legs and avoid any other injuries.
Your physiotherapist may also advise that you:
- To wear shoes with a slightly raised heel, this aims to relieve the pressure placed directly on the growth plate.
- Stretching exercise can be useful to reduce tissue tightness that can contribute to your pain in the heel.
- Heel pads can be used inside your boots/shoes to help absorb impact and relieve stress on the heel and growth plate
- Non-steroidal anti-inflammatory drugs like ibuprofen can help reduce the swelling and pain in your heel to allow you to continue your day to day activities.