9 Best Sever’s Disease Calcaneal Apophysitis Exercises To Cure Heel Pain

Calcaneal apophysitis is a common condition in adolescents characterized by heel pain. This post will be covering the causes, symptoms, and most importantly the treatment for calcaneal apophysitis, including how to cure heel pain for good. These 9 physical therapy calcaneal apophysitis exercises are the most effective treatment to decrease pain.

What is Calcaneal Apophysitis?

Calcaneal apophysitis and sever’s disease are two terms for the same condition. Calcaneal apophysitis occurs when the growth plate in the back of the heel becomes inflamed.

This inflammation of the growth plate can cause pain. The heel bone is also called the calcaneus bone.

As many as 8% of overuse pediatric injuries are calcaneal apophysitis. This is why it is so important to learn the signs and symptoms of calcaneal apophysitis and how to effectively treat it long term.

Anatomy

A child is growing and will have open growth plates. A growth plate is an area of cartilage that surrounds the end of bones. This is where bone growth occurs. When a child is fully grown solid bone will replace this cartilage.

The Achilles tendon attaches to the calcaneus. The tendons of the growing foot can also become inflamed with repetitive stress.

Causes Of Calcaneal Apophysitis?

Calcaneal apophysitis is most common in adolescents during a growth spurt. This is most common specifically in young athletes between 8 and 13 years of age who participate in high-impact sports such as running or jumping activities, especially on hard surfaces.  However, it can also occur in less active adolescents wearing flat shoes.

In short, any type of physical activity that causes repetitive stress can cause sever’s disease. Late adolescence is the most common age to develop calcaneal apophysitis.

Symptoms Of Calcaneal Apophysitis

Calcaneal apophysis is the most common cause of heel pain in young athletes. This acute pain in the heel is usually localized to the back of the heel and underneath the heel. It can also result in mild swelling in the heel.

Calcaneal apophysitis does not typically cause ankle pain, however, if a child is compensating enough when walking and jumping, it may cause ankle pain.

Diagnosis Of Calcaneal Apophysitis

If your child is in constant pain which is localized to their heel it is a good idea to see your child’s doctor.

A physical examination by your doctor or health care provider will be able to diagnose your child’s condition. The doctor will need to determine the type of heel pain that you are experiencing.

Although an X-ray will not effectively show if your child has Calcaneal Apophysitis, it will effectively rule out another medical condition or other injuries such as stress fractures. 

Calcaneal Apophysitis In Adults

Adults do not suffer from calcaneal apophysitis because calcaneal apophysitis involves the growth plates. Adults growth plates are closed for many years by the time they reach adulthood. They may be misdiagnosed for calcaneal apophysitis when they have another condition causing heel pain such as plantar fasciitis.

Calcaneal Apophysitis Treatment

There are a few treatment methods to improve heel pain that is caused by calcaneal apophysitis. The majority of cases of sever’s disease can be treated conservatively with a combination of physical therapy exercises and a change of footwear.

A heel cup or heel cushion can be placed in the shoe for added support. A heel lift will assist with pain relief.

The most effective way to treat calcaneal apophysitis is through physical therapy. These 9 calcaneal apophysitis exercises focus on both strengthening and stretching the muscles around the heel.

Calcaneal Apophysitis or Sever’s Disease Physical Therapy Protocol

The best physical therapy protocol for calcaneal apophysitis or sever’s disease includes consistent calcaneal apophysitis stretches, ankle and foot strengthening exercises, deep tissue mobilization and activity modification.

The calcaneal apophysitis stretches included in this protocol are the soleus stretch, gastroc stretch and towel stretch.

Calcaneal Apophyitis Stretches

Calcaneal apophysitis stretches include the 1. Soleus Stretch 2. Gastroc Stretch 3. Towel Stretch. These stretches focus on stretching the calf muscles (soleus and gastrocnemius) to relieve tightness.

1. Soleus Stretch

• Most children with calcaneal apophysitis will have tight calf muscles.
• There are 2 calf muscles.
  • The first is the soleus muscle.
• To stretch this muscle, you will stand facing a wall with your affected leg behind you.
• You will now bend both of your knees and push your back heel into the ground.

2. Gastroc Stretch

• The gastrocnemius muscle is the other muscle in the calf.
• To stretch this muscle, you will stand facing a wall with your affected leg behind you.
• You will keep your back leg straight and your front leg bent.
• Now push your back heel into the ground.

3. Towel Stretch

• Lie down with a towel around your foot and pull your foot and ankle towards you.
• Hold this stretch for 30 seconds.
• For a better stretch you can perform this exercise with a stretch band listed below.

Calcaneal Apophysitis Or Sever’s Disease Physical Therapy Exercises

A combination of calf stretching exercises, and foot and calf strengthening exercises are the best way to treat calcanea apophysitis or sever’s disease. These physical therapy exercises include 4. Towel Scrunch 5. Single Leg Heel Raise 6. Two Leg Heel Raise 7. Resisted Dorsiflexion 8. Toe Walking 9. Walking Lunges.

4. Towel Scrunch

• This exercise helps to strengthen the plantar fascia in the foot.
• It is also a common exercise used to treat both calcaneal apophysitis and plantar fasciitis.
• Plantar fascia is the soft tissue at the bottom of the foot which can get tight.

5. Two-Legged Heel Raise

• Stand next to a wall or sturdy surface and push up onto both of your toes.
• Now slowly lower your heels back down to the floor.

6. Single Heel Raise

• This is a progression to the previous exercise.
• Stand next to a wall and push up onto only one leg.
• This exercise prevents you from being able to compensate with the other leg.

7. Resisted Dorsiflexion

• Lie down and place a resistance band attached to a sturdy object in front of you.
• Now bend your ankle towards you.
• If you have a loop resistance band you can perform this exercise by putting it around both of your feet and then lifting your toes off the ground into the resistance band.

8. Toe Walking

• You will need 10 feet of open space for this exercise.
• Now rise onto your toes and walk back and forth while keeping your heels off the ground.

9. Walking Lunges

• This is a great strengthening exercise for the entire lower body.
• Start by taking a large step forward and bending both of your knees.
• Your back knee should bend straight down towards the floor.
• Now take a big step with your back leg, past your front leg and perform another lunge.
• Keep doing this for 10 steps and then turn around.

Sever’s Disease Heel Cups

Heel cups can be placed in a shoe and are designed to offload pressure on your heel and thus decrease heel pain. These are custom and non custom heel cups. Both have been found to be beneficial in supporting the foot and decreasing heel and shin pain in children with sever’s disease.

Summary of Calcaneal Apophysitis Exercises

The most common causes of heel pain are overuse and repetitive activities. All of this can result in calcaneal apophysitis. These 9 calcaneal apophysitis exercises will improve your child’s heel pain and get them back to all of the activities that they love!

These exercises will help your child get back to a pain-free life. If your child has flat feet they may need to perform additional physical therapy exercises to improve their arch. You can find 11 Best Treatment Exercises For Flat Feet here.