see also:

• arthritis - clinical patterns
• Vic. Better Health - patient fact sheet - Sever's disease

• a cause of heel pain in pubertal adolescents which is exacerbated by running and jumping activities, first described by J.W. Sever in 1912 ¹⁾
• most commonly affects boys aged 12 to 14 years and girls aged 10 to 12 years
• usually subsides by the age of 17 if chronic symptoms appear and does not cause long term problems.

• plantar fasciitis:
  • inflammation of the ligament that runs from the heel bone along the sole of the foot.
  • causes include flat feet and stiff shoes
• bursitis:
  • common causes of bursitis at the back of the heel include injury, overuse and tight shoes.
• Achilles tendonitis
  • the Achilles tendon attaches the calf muscle to the heel. Inflammation of this tendon can be caused by stiff calf muscles and running on hard surfaces like concrete or bitumen.
• stress fracture
  • a hard impact or awkward landing may fracture the heel bone

• largely clinical supported by plain Xray
• plain Xray shows increased density and/or fragmentation of the Achilles apophysis on the posterior aspect of the calcaneum.

• rest, ice
• flexibility exercises to help lengthen the lower leg muscles
• shoe inserts may help
• non-weight bearing exercises such as swimming and cycling once initial symptoms settle
• analgesics
• time - it may take 2-8 weeks for the symptoms to settle with avoidance of running and jumping.