Growing Pains part 2

Sarah Thomas
Sarah Thomas Physical Therapist at AHS

Last week I discussed Osgood Schlatter’s Disease. Today I’m going to talk about another issue that can occur during adolescence known as Sever’s disease. Sever’s disease known as calcaneal apophysitis is an inflammation of the heel. This is due to repetitive small traumas from traction of the Achilles tendon at the bone growth center of the calcaneus (heel bone). This causes calcaneal apophysis damage.

Causes/Risk Factors:


This inflammation tends to happen when the biggest changes are occurring to the muscle, bones and tendons. This happens during a growth spurt. More active children are at a higher risk because of the increased stress put on the joint and tendon. High impact sports such as gymnastics, basketball and football have a higher incidents rate. Why does growing hurt there? The end of bones in children and adolescents have a growth plate. The physis is the weakest point in the muscle-tendon-bone-attachment (as opposed to the tendon in an adult) and therefore, at risk of injury from repetitive stress.  Onset coincides with adolescent growth spurts between ages 10 to 15 years for males and 8 to 13 years for females.

Signs and Symptoms

There usually isn’t pain when first getting up in the morning. The area often feels stiff and pain increases with weight bearing, running or jumping. Often times there is limited dorsiflexion ROM. Pain improves with rest.


Exercise therapy consists of flexibility and strengthening exercises of the surrounding hip, knee, and ankle muscles.  Therapy will may involve stretching of the triceps surae (calf muscles) and strengthening of toe extensors and plantar fascia stretching. It may include mobilizations to the foot and ankle to increase range of motion.  Taping may be used for pain management and to relief inflammed tissue.

Low-intensity exercises are done in the beginning of rehab and are gradually progressed to tolerance. Activities should be modified to limit further overuse injury. 

Prognosis is excellent for most cases and symptoms are temporary and tend to decrease within 1-2 months. Non-operative treatment has been effective when exercises are done for the appropriate duration with emphasis on proper alignment and techniques.

How can we help?

Here at Allied Health Solutions we have experience treating this condition. We believe one treatment does not fit all and will customize your treatment plan to your needs. We will use hands on therapy techniques to reduce pain and help you return to the activities that you love to do.

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