By Kimberly Marselas
At the height of soccer season, Dr. Adrienne Spirt sees up to five patients a week with the same symptoms: a throbbing pain in the heel and tightness through the calf muscle. Based on her patient’s age, Spirt can often diagnose the problem within a few minutes: Sever’s syndrome.
Sever’s (pronounced See-vers) is a temporary but often painful disorder resulting from inflammation of the heel. It usually strikes children between the ages of 8 and 13, while their growth plate is still developing and cartilage is calcifying into bone. Active children, like those involved in running-dominated sports like soccer, field hockey and lacrosse, are especially prone.
“Most of the kids who develop this are playing sports,” says Spirt, an orthopedic surgeon specializing in foot and ankle problems at the Orthopaedic and Sports Medicine Center at Anne Arundel Medical Center. “Usually it will resolve itself in two to three months, but it’s not uncommon to have a reoccurrence in the future.”
Major contributing factors are repetitive use, obesity, a tendency to pronate or roll the foot inward when walking, and flat arches. Some doctors say the number of Sever’s cases is increasing because students are specializing in one sport at an earlier age, meaning their feet don’t get a break from heavy pounding on the turf.
“Anecdotally, people are saying they feel like they’re seeing it more,” says Dr. Daniel Farber, an orthopedic surgeon specializing in foot and ankle injuries at University of Maryland Medical Center. “In my practice, I see it as more cyclical. You tend to get it a bit in the spring and the fall as athletes are ramping up their activity.”
Farber says sports with “push-off” motions, including basketball and baseball, also make players susceptible. The factor most at play among Farber’s pediatric patients is a tight heel chord, which puts stress on the entire area between the plantar fascia (the connective tissue that runs from the heel to the toes) and the Achilles tendon.
“Something’s got to give,” says Farber. “The growth plate is really what takes the brunt of it.”
And when not given enough time off, the heel will also become intensely inflamed. A key symptom is refusal to bear weight on the affected foot.
George Kalas III learned about Sever’s the hard way. Though his son, Gus, had been favoring his right foot for months and eventually began limping, the 9-year-old wouldn’t acknowledge the pain. During a lacrosse game last fall, the condition finally became intolerable.
“He could hardly put any weight on it,” says Kalas, of Davidsonville. “I had to carry him off of the field.”