Sever’s Disease vs Plantar Fasciitis

Sever’s Disease vs Plantar Fasciitis

Sever’s Disease vs. Plantar Fasciitis

 Severs Disease vs Plantar Fasciitis – Heel pain is a frequent problem, particularly for those who are physically active or spend considerable time on their feet. Various causes can contribute to a painful heel. In some cases, it may be mild and manageable at home by using an ice pack or temporarily pausing your activities for several days.

However, there may be instances when more than just a brief respite is needed. The underlying issue could be an injury, plantar fasciitis or Sever’s disease.

East Gosford Podiatry, as the leading podiatrists on the Central Coast, strives to provide valuable information to help individuals differentiate between various foot and lower limb conditions. Severs Disease and Plantar Fasciitis are two common conditions that cause heel pain and while they share some similarities, there are crucial differences between them.

Severs Disease: Overview, Causes, and Symptoms

Severs Disease, also known as calcaneal apophysitis, predominantly affects children and adolescents during growth spurts, typically between the ages of 8 and 15. Although it’s commonly called “Severs Disease,” it isn’t an actual disease, but rather a stress reaction in the growth plate or apophysis of the heel bone (Calcaneus). It occurs when the heel bone (calcaneus) is not fully developed, and the growth plate in the heel experiences repetitive stress from physical activities, resulting in inflammation and pain. Severs Disease symptoms include pain at the back or sides of the heel, which tends to worsen with activity and improve with rest.

Calcaneal Apophysitis is a frequent source of heel pain in physically active children.

The inflammation is believed to result from a combination of excessive traction force from the calf muscles through the Achilles tendon and excessive ground reaction force.

The condition often emerges during rapid growth periods around puberty, with symptom peaks appearing at different ages for girls and boys:

Symptoms of Calcaneal Apophysitis

A child may experience pain in one or both heels during or after physical activity. Symptoms often worsen upon waking up in the morning or after resting following exercise.

  • A child might exhibit limping or show reluctance to participate in activities involving running or jumping.
  • Calcaneal Apophysitis can often be diagnosed through a positive “squeeze test.” X-ray imaging is generally not helpful or necessary.

Common Causes of Calcaneal Apophysitis

  • Sudden height or weight increases related to growth spurts.
  • Rapid escalation in sports or activities, particularly those involving explosive movements like running and jumping.
  • Playing or training on hard surfaces.
  • Restricted ankle mobility, frequently due to calf muscle tightness.
  • Inadequate footwear for the chosen activity.
  • Potentially poor biomechanics and excessive rearfoot pronation (there are varying opinions on how this might contribute to symptoms).

Plantar Fasciitis: Overview, Causes, and Symptoms

Plantar Fasciitis is a prevalent foot condition that usually affects adults, causing pain at the bottom of the heel. It results from inflammation of the plantar fascia, a thick band of tissue connecting the heel bone to the toes.  This ligament, which connects the heel to the front of the foot, can become damaged due to wear and tear or injury over time. The plantar fascia primarily acts as a shock absorber and offers support to the arch of the foot. Excessive pressure on the feet can lead to inflammation or stiffness in the plantar fascia.

Causes of Plantar Fasciitis

The causes of Plantar Fasciitis can be varied and often involve a combination of factors. Some of the common causes include:

  • Age: Plantar Fasciitis is more common in individuals aged between 40 and 60 years old.
  • Obesity: Carrying excess weight puts additional strain on the plantar fascia, increasing the risk of inflammation.
  • Foot mechanics: Abnormal foot structure, such as high arches, flat feet, or excessive pronation, can contribute to the development of Plantar Fasciitis.
  • Occupation: Jobs that require prolonged standing or walking on hard surfaces can increase the risk of developing the condition.
  • Physical activity: Certain types of exercises, such as long-distance running, ballet dancing, and aerobic dance, can place excessive stress on the heel and surrounding tissues, leading to Plantar Fasciitis.
  • Inappropriate footwear: Wearing shoes with poor arch support, inadequate cushioning, or worn-out soles can contribute to the development of the condition.
  • Tight calf muscles or Achilles tendon: Tightness in the calf muscles or Achilles tendon can create tension on the plantar fascia, increasing the risk of inflammation.

It is essential to understand that Plantar Fasciitis can result from a combination of these factors, and addressing the underlying causes can help in the effective management and prevention of the condition.

Symptoms of Plantar Fasciitis

The most common symptom of plantar fasciitis is pain at the bottom of the heel or midfoot area. It can affect just one or both feet.  This can either be an ache or a stabbing pain that will occur when you are on your feet.

Symptoms of Plantar Fasciitis include:

  • Sharp or aching pain in the inside bottom part of the heel
  • Heel Pain
  • Swelling

Q: What is the difference between Severs and plantar fasciitis?

 A: The primary differences between Severs Disease and Plantar Fasciitis include the age of those affected, the location of the pain, and the underlying causes. Severs Disease is typically observed in children and adolescents, while Plantar Fasciitis is more common in adults. Severs Disease causes pain at the back or sides of the heel due to growth plate inflammation, while Plantar Fasciitis causes pain at the bottom of the heel due to plantar fascia inflammation.

 Q: How do I know if I have a heel spur or plantar fasciitis?

 A: Heel spurs are bony growths on the underside of the heel bone, and while they can cause pain, they often exist without symptoms. Plantar Fasciitis pain tends to be worse in the morning or after periods of inactivity, whereas heel spur pain is usually constant and may feel like a sharp poking sensation. A podiatrist can accurately diagnose the condition through physical examination, patient history, and imaging studies.

 Q: What can be mistaken for Sever’s disease?

 A: Conditions that can be mistaken for Sever’s disease include Achilles tendonitis, stress fractures, and other heel bone injuries. A thorough examination by a podiatrist is necessary to differentiate between these conditions and provide an accurate diagnosis.

 Q: What is the difference between Sever’s disease and Achilles tendonitis?

 A: Sever’s disease is an inflammation of the growth plate in the heel, while Achilles tendonitis is an inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. Although both conditions cause heel pain, they have different underlying causes and typically affect different age groups.

 Q: What are 2 symptoms of plantar fasciitis?

 A: Two key symptoms of plantar fasciitis are pain at the bottom of the heel and stiffness in the foot, especially upon waking up or after periods of inactivity.

 Q: What are 3 treatments for plantar fasciitis?

 A: Three common treatments for plantar fasciitis include:
Rest and reduced activity
Ice application Stretching exercises and physical therapy

Q: What is the squeeze test for Sever’s disease?

A: The squeeze test is a diagnostic tool used by podiatrists to identify Sever’s disease. It involves gently squeezing both sides of the heel, where the growth plate is located. If the child experiences pain or discomfort during this test, it is considered a positive result, indicating the presence of Sever’s disease.

 Q: What is a positive squeeze test for Sever’s disease?

 A: A positive squeeze test for Sever’s disease occurs when the child experiences pain or discomfort while the podiatrist gently squeezes both sides of the heel. This pain indicates inflammation of the growth plate and is suggestive of Sever’s disease.

 Q: Can my child still play sports with Sever’s disease?

 A: While it is possible for a child with Sever’s disease to continue participating in sports, it is crucial to manage their activity level and monitor their pain. In some cases, it may be necessary to reduce or temporarily stop certain activities that exacerbate heel pain. Consulting with a podiatrist can help determine the appropriate course of action, which may include modifications to footwear, orthotics, or participation in low-impact activities until the condition improves.


Sever’s Disease and Plantar Fasciitis 

Sever’s Disease and Plantar Fasciitis are distinct conditions with different causes, symptoms, and treatments, despite both causing heel pain. Accurate diagnosis and appropriate treatment are essential for managing these conditions effectively. If you or your child are experiencing heel pain, consult with a qualified podiatrist, such as those at East Gosford Podiatry, to receive a proper diagnosis and a tailored treatment plan.

We Accept Patients from all over the Central Coast

If you are in East Gosford and surrounding suburbs and are in need of a Podiatry appointment due to lower limb or feet issues you may need orthotics. Please contact our clinic on (02) 4325 0600

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