Prevention and management of calcaneal apophysitis in children: an overuse syndrome.

Micheli LJ, Ireland ML. J Pediatr Orthop 1987 Jan-Feb;7(1):34-8.

Calcaneal apophysitis (Sever disease) is a common cause of heel pain, particularly in the athletically active child. Eighty-five children (137 heels) with calcaneal apophysitis were reviewed. Both heels were affected in 52 (61%) patients. The most common associated foot condition was pronation, occurring in 16 patients. Sixty-eight patients complained that pain was made worse by a specific sport, with soccer leading the list. All patients were treated with a physical therapy program of lower extremity stretching, especially of the heel cords, and ankle dorsiflexion strengthening. Soft Plastizote orthotics or heel cups were used in 98% of patients. Proper athletic shoewear was advised. All patients improved and were able to return to their sport of choice 2 months after the diagnosis. There were two recurrences.