Sever's disease and other causes of heel pain in adolescents

Sever's disease, or apophysitis of the calcaneus, is a common but frequently undiagnosed source of heel pain in young athletes. This condition frequently occurs before or during the peak growth spurt in boys and girls, often shortly after they begin a new sport or season. Sever's disease often occurs in running and jumping sports, particularly soccer. Patients present with intermittent or continuous heel pain occurring with weight bearing. Findings include a positive squeeze test and tight heel cords. Sever's disease cannot be diagnosed radiographically. The condition usually resolves two weeks to two months after the initiation of conservative treatment, which may include rest, ice application, heel lifts, stretching and strengthening exercises, and, in more severe cases, nonsteroidal anti-inflammatory drugs.