Sever's disease, or calcaneal apophysitis, is the primary cause of heel pain in pediatric patients between the ages of 8 and 15 years. Primary risk factors in pediatric athletes are obesity and high levels of physical activity. Sever's injury primarily results from high-impact sports such as soccer, track, cross-country, gymnastics, tennis, and ballet. This injury mainly occurs during puberty with an open growth plate in the immature calcaneus. Clinical diagnosis can be confirmed by performing a “squeeze test” of the heel on physical examination. Diagnostic imaging findings include increased sclerosis and fragmentation of the calcaneal apophysis on plain radiograph x-rays. Ice, activity restriction, stretching, nonsteroidal anti-inflammatory drugs, immobilization, and heel cups are all methods that can be utilized in treating the pain caused by Sever's. No long-term effects have been associated with Sever's disease.
School of Nursing and Health Sciences, Robert Morris University, Moon Township, and Emergency Department, Heritage Valley Esmark, Sewickley, Pennsylvania (Dr Ramponi); and Heritage Valley Health System, Sewickley, Pennsylvania (Ms Baker).
Corresponding Author: Denise R. Ramponi, DNP, FNP-C, ENP-BC, FAEN, FAANP, CEN, School of Nursing and Health Sciences, Robert Morris University, Moon Township, PA 15108 (firstname.lastname@example.org)
Medical illustrations by Nicole Eaton, Media Arts Student, Robert Morris University.
Disclosure: The authors report no conflicts of interest.