Sever’s Disease -Ankle Issues in kids

Pain at the Growth Plate, typically in super active kids and young athlete’s. Don’t let the term “disease” influence you. learn more.

If you have read any of my “named conditions” articles you know I have a really hard time being OK with named conditions, especially those that are common with kids and athletes being tagged, “A Disease.”

Pick any other term, please!!


Call it a “condition, syndrome, variant, or just “Sever’s” as a stand alone. Anything but “disease.”


I preach the same with “Osgood Schlatter’s, degenerative disc disease, and even sprained ankles.” In my clinic, when I treat these issues I am very adamant about the idea that UNDERSTANDING is a much better idea than using a term.


Better terms and understanding results in better recovery and care.


Here’s my disclosure. My own daughter was diagnosed with this, via my own treatment of her and the radiology I ordered. These hurt. She hurts. But as her daddy, when I explain this to her and she understands it, she will feel better. She’ll know it’s not an emergency, she’ll understand she won’t die from this and that she doesn’t need surgery. She’ll know she won’t be deformed forever and maybe every bit as important as all of those, she’ll know with 100% certainty that she will play sports again.


That’s what dads are for. That’s what doctors should be for as well.


“Will I be back?” This question and the above ideas MUST be tackled immediately. I’m not sure “disease” in the name allows for this.


So what is going on in Sever’s condition? Let me explain it in simple terms you all can understand. Feel free to share this with your friends and their kids. It is quite treatable and you will come through this like a champ!


All kids have growth plates. Growth plates are the areas in the bone that are constantly changing. They are growing at all joints and are particularly vulnerable to extra stresses.
Most full grown adults have around 206 bones. Kids still have over 300 separate bones that as they grow start to mesh and fuse together.


In Sever’s, the growth plate at the back of the heel bone (calcaneus) is the area affected. In medical terms the growth plate is called the apophysis. And the medical terminology for Sever’s is technically apophysitis. (apoph=growth plate itis=inflammation)

(Dr. Sever categorized the condition over 100 years ago and the condition is named after him. Back in those days everything named was kind of commonly thought of as a “disease.” Dis-ease meaning, not perfect.)

The trouble is, these growth plates are very important and you don’t want to have anything disrupt the proper time frame of the human body’s development. So it is important to stop activities that are irritating any issues.

This again comes back to the trouble with Sever’s being considered a disease and oftentimes when pediatricians diagnose this despite their well-being, it puts a level of fear into the parents- where any activities are cut out… indefinitely.

While speaking at a career day at the middle school just last week I had one of the kids ask me if I had ever heard of Sever’s disease. I told him, ”I treat these all the time.” and he told me he suffers from this “disease” and his parents no longer let him do Sports.


I told him to tell his parents he has or maybe even HAD inflammation of a growth plate and modern doctoring clearly states that a return to activity after the condition has recovered is 100% appropriate and recommended!

Because this “never doing activity again” breaks my heart. It’s not good for kids or the planet. If anything, the world needs MORE activity. I truly believe this and have a sign in my clinic that reads “Ask your doctor if getting off your ass is right for you!”


“Deconditioned” is the biggest true disease of the planet and we’re OK with this for our kids?


My daughter is also going through this condition and she is going to have to take some time off and not do sports. But that is not forever. It is a temporary problem. As the growth plates start to recover, the inflammation goes down, and the proper treatment of the surrounding areas is happening, she should respond and will respond just fine. In fact I would argue, (and often do) that limiting any kind of motion through the foot and ankle is a sure way to cause all kinds of problems throughout the entire human body. Motion has to happen here. The Foot and Ankle have 26 bones and nearly 70 different muscles. This is an incredibly Mobile area so it needs to remain so.

While going over this condition with one of my friends who is a pediatric orthopedic surgeon we were discussing the modern treatments of this issue. Where, in the past, Sever’s treatment protocol was typically treated utilizing a boot to restrict motion, this is not in-Vogue anymore. Much like you rarely see shoulder slings being utilized- Physiotherapists, PT’s, sports-based chiropractors and doctors that work with athletes realize mobile parts of the body need to remain as mobile as possible, especially through rehab and treatments. That is not to say that if your treating practitioner suggests a boot, you should disregard that advice. Indeed, there is a time to let the body heal. But be careful of weeks of immobilization.


This article is built as an understanding only, not medical advice. But I think it is only proper to give the reader modern treatment options and protocols while discussing the condition.


The treatment that I will utilize while working with my own daughter is to First: Give her some major rest. She is, sports speaking, “shut down.” As we monitor her pain levels and inflammatory actions and they start to come under more control we will then use a return-to-play protocol involving simple movements and a stair-step approach back into more Dynamic complex movements and eventually a return to Sports. We will definitely not, “Just rest for 6 weeks and then jump right back in!” (return to play criteria)


This is a bummer. For the athlete, the parents, the team. But, these conditions have to be treated properly. They are not going to just, “ go away on their own.”


Kids are resilient. They bounce back and heal quickly. But growth plates are nothing to mess around with. These need to be healed and healed up perfectly.

Hopefully this article gives you a better detailed understanding of the condition and most importantly, let’s you think a little bit differently about the term “disease” in modern medical terminology.


Better terms and understanding results in better recovery and care.

Like I say during my lectures about patient care, “We can call a sprained ankle a “sprained ankle” or a “partial rupture of the distal aspect of the calcaneofibular ligament” to describe the same injury. One term is easy to understand. Recovery is possible and you immediately understand that you’ll “Be back.” One is terrifying and sounds incredibly severe and most likely causes doubt in athletes and patients about the long term effects.

Simplify. Be smart. Care more.

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