Calcaneal apophysitis (Sever's disease) — a common cause of heel pain in young athletes

The most common syndromes in young athletes are apophysitis, especially Osgood-Schlatter and Sever's disease. According to a retrospective questionnaire of 67 patients with Sever's disease treated at the Sports Medical Research Unit in Turku, the main sports causing this syndrome were related to running. The pain appeared on average at the age of 12.2 years (boys 12.5 and girls 11.8) and was unilateral in 85% of the cases; 54% of the patients were boys. The pain was typically worst at the end of exercise and afterwards. On average, the patients were forced to stop training because of pain for 1.3 months (< 2 weeks in 55% of the patients) and the syndrome interfered with fully effective training for 2 months in 28% of the cases. After a 2-month symptom-free period, Sever's disease recurred in 28% of the cases. Later, 48% of the patients contracted also Osgood-Schlatter disease. The diagnosis of Sever's disease is clinical and the treatment is symptomatic. Sever's disease is cured by the fusion of the epiphysis with the calcaneal bone.