Sever's Disease

What Is Server’s Disease?

Server’s Disease is a common foot concern found in children. This can affect active, healthy children and causes pain in one or both heels. It is most likely that pain will occur after walking, running or engaging in physical activity. Server’s disease can cause swelling and irritation, primarily on the underside or the back of the heel.

Server’s Disease is also called calcaneal apophysitis. The calcaneal is the heel bone and apophysitis means painful inflammation of the plate of the foot. Server’s is commonly recorded in children aged 8 – 14 year olds.

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Symptoms and Causes of Server’s Disease?

Foot pain, and even lower leg or knee pain is extremely common in children or adolescents, due to the fact that they are constantly growing. In most children, the heel bone (calcaneus) is not fully developed until the age of 14 or older. Until then, new bone is forming at the growth plate of the foot (the apophysis, located at the back of the heel), an area which is softer than others due to its role in accommodating the growth.

Repetitive stress on the growth plate due to walking, running and sports causes inflammation in the heel area. Because the heel's growth plate is sensitive, repeated running and pounding on hard surfaces can result in paediatric heel pain. Children and adolescents who take part in a lot of sport are especially vulnerable. Over-pronation (fallen arches and rolling inwards of the feet) will increase the impact on the growth plate and is therefore a significant cause and a major contributing factor to heel pain in children. Symptoms of Server’s Disease includes:

  • Swelling
  • Obvious redness and heat in the heel
  • Limping or avoiding putting weight on the feet
  • Pain in the heel

Server’s Disease is a misnomer. Although it is referenced as a disease, it is not contagious.

How To Treat Server’s Disease?

Depending on the Podiatrist's diagnosis and the severity of the pain, there are several options for Server’s Disease treatments, including:

  • Rest/reduced activity: your child should reduce or stop any activity that causes pain, such as sports and running. This can be a difficult option, as children are normally quite wilful in pursuit of their favourite pastimes!
  • Over the counter anti-inflammatory drugs, such as ibuprofen (found in Nurofen), to help reduce pain and inflammation. It is best to avoid medication wherever possible, as tolerance, particularly in children can build up. Integrate natural anti-inflammatory creams with standard medication, such as First Honey
  • Conditioning exercises can also help to combat the progression of Server’s Disease. These can be practiced before physical activity, sport and play. Server’s Disease exercises are designed to strengthen the plantar fascia This will reduce the experience of pain in the heel.
  • The use of Orthotic insoles. Foot Active Kids orthotics are made for children, for shoe sizes 11-13 and 1-2½. They will help properly support the foot, help prevent over-pronation or improper gait, restoring your child's foot to the correct biomechanical position. For shoe sizes above 2½ we recommend our adult medical ¾ length range, available from size 3 upwards. If you are in any doubt or your child's foot pain persists then please arrange an appointment with a Podiatrist or Physiotherapist.

For more information on how to support your child with Server’s Disease or advice before you buy our podiatrist-approved shoe inserts, contact the team at Foot Active today!