What to do about Sever’s Disease

Sever’s disease is a very common problem in children and early teenagers that are still growing. The proper term for Sever’s disease is calcaneal apophysitis and probably should be used, but we are for now sticking to the common name. It is an excessive use type injury of the growth plate at the back of the heel bone. This is a self-limiting problem, in that the teenager will always grow out of it when growth and development in the bone stops, usually about the mid-teenage years. The common and typical symptom are pain at the back and sides of the heel bone, especially after taking part in sport. What exactly causes it is not totally clear, but it is an overuse injury as it is more common in children who are more active.

One of the better discussions on this condition is this video interview on Calcaneal apophysitis (Sever’s disease) from PodChatLive interviewing an expert on this:

The treatment of Sever’s disease is not that difficult and is simply a matter of managing the loads that the child puts on the heel bone and the lifestyle, and their expectations, perhaps with heel pads and just waiting for the natural history of the condition to takes its course. Children are notorious for not listening when instructed to reduce their loads, so this does have to be done with the parent’s involvement and some negotiation

Plantar Plate Tear Exercises

A plantar plate tear or strain is a common problem that causes pain in the ball of the foot. The pain is usually right under or just in front of the metatarsophalangeal joint of one or more toes. It is almost always due to overuse. The most common treatment is strapping to hold the toe in a plantarflexed position. It is common asked in forums and in social media about what exercises can be done for a plantar plate tear. Firstly, the mainstay of the treatment is the strapping, probably a metatarsal pad and maybe a stiff soled shoe. Secondly, there is next to no research on the affect of exercises for this condition. The exercises will probably be of some help, but in comparison to the other treatment options that help will not be great.

That does not mean do not do the exercises as even if they do not help the plantar plate tear, they will help your overall foot health and conditioning, so they may be just worth it for that reason.

What exercises are useful?

There are many recommendations for exercises for plantar plate tears.