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

J Pediatr Orthop. 1987 Jan-Feb;7(1):34-8. doi: 10.1097/01241398-198701000-00007.


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.

MeSH terms

  • Adolescent
  • Athletic Injuries / prevention & control
  • Athletic Injuries / therapy*
  • Calcaneus*
  • Child
  • Female
  • Humans
  • Male
  • Pain / etiology
  • Pain / prevention & control
  • Pain Management*
  • Physical Therapy Modalities
  • Recurrence