What’s the treatment for Sever’s disease? Our eleven-year-old daughter was just diagnosed with this. They say she will have to give up her gymnastics for awhile. What else?

Sever’s disease, also known as apophysitis of the os calcis is a condition seen most often in gymnasts. Let’s breakdown the terms first. Apophysitis refers to a tuberosity (bony bump) that is stressed when an attaching tendon pulls on it repetitively.

In this case, that bony bump is on the os calcis or heelbone. The offending tendon is usually the Achilles tendon that attaches the calf muscle to the foot. The insertion point is an area of near the place where the bone grows and eventually ossifies or hardens.

Young athletes whose bones have not yet completed growing can develop problems during growth spurts. Gymnasts with Sever’s disease develop heel pain, ankle pain, and sometimes midfoot pain or discomfort.

Conservative (nonoperative) care consists of stretching the calf muscle (called the gastrocnemius), strengthening of the muscles that oppose the gastrocnemius, and orthotics or shoe modifications. Sometimes special cups that fit inside the heel of the shoe are used. Some patients respond well to a heel lift or heel wedge.

The athlete may be told to stop all running activities. With the right program of stretching and strengthening, the condition will slowly get better over a period of one to four weeks. For young athletes who probably won’t cooperate, a short-leg cast may be used to hold the foot and ankle in a static posture until healing takes place.