This is an interesting one. According to a search engine keyword tool, the phrase ‘severs disease in adults‘ is searched for up to 700 times a month! That is 700 people looking for information on Server’s disease (Calcaneal apophysitis) occurring in adults. It is impossible for Severs disease to occur in adults, so I am not so sure what they are actually looking for.
Severs disease is a disorder of the growth plate at the back of the calcaneus. That growth plate merges with the rest of the calcaneus about the mid-teenage years. There is no growth plate there after that time, so it is impossible for Severs disease to be a problem in adults.
It could be that people are searching for information if the Severs disease that children get can continue to be a problem as they become adults (it doesn’t).
It could be that they have heard that Severs disease is common in children and they want to know if it could be the cause of there heel pain as an adults (its not). Heel pain is reasonably common in adults and it has many causes. Severs disease is just not one of them.
This is a common topic I write about often. I wrote here about just how much I learnt about the condition when my own daughter got it and just how much that subsequently influenced my management. We did a PodChatLive on it with Alicia James and I published my unscientific study on it here.
Firstly, it should be called Calcaneal apophysitis and not Sever’s disease, but I still use Sever’s disease as that is way more common in the search engines when you want your writing to show up.
Secondly, as I said in my unscientific study, I not sure we can do much to help it. The big problem with Sever’s disease is that if you take 100 kids with and do nothing, x% will be a lot better next week. If you took another 100 and did something, then x% would be better next week, so did ‘something’ work or was it the natural history that was the reason for the improvement.
I know when you visit Podiatry Facebook groups and other social media and see discussions on Sever’s disease, so many have there views on what should be done. I have to fight myself really hard not to get involved in arguments, but I often want to ask them how do they know the treatment that they are advocating actually works and that the improvement that they are seeing is not just the natural history that you would expect to see. They actually have no way of knowing unless what they are advocating has been tested in a proper well controlled prospective randomized study.
So what do I do for Sever’s disease. Not a lot. Educate them on the nature of the condition and the natural history; discuss how to manage the loads and use a cushioned heel pad.