- A frequent cause of heel pain in children and adolescents resulting from a traction apophysitis of the calcaneal apophysis
- Frequently associated with repetitive use and sports participation
- The incidence is not currently known.
- In a cross-sectional study from the European Journal of Pediatrics done by Wiegerinck et al. published in 2014, 16,383 SOAP files from patients 6 to 17 years old visiting their general practitioner between 2008 and 2010 were analyzed and 61 children were identified with an incidence of 3.7 per 1,000.
- The prevalence is not currently known.
- In a study done by Suzue et al. published in 2014, 1,162 junior soccer players were evaluated by questionnaire and 49 were diagnosed by exam and imaging as having Sever disease (1).
Etiology and Pathophysiology
- Microtrauma occurs at the calcaneal apophysis as a result of repetitive traction on the calcaneal epiphysis by the Achilles tendon during concentric plantar flexion and eccentric dorsiflexion (2).
- Inflammation at the apophysis leads to pain and possible limping with activity.
There is not a genetic predisposition to this condition.
- Stretching and strengthening of gastrocnemius–soleus complex
- Wear appropriate footwear with adequate heel support.
- Intermittent periods of rest from aggressive physical activity and adequate recovery periods following individual bouts of exercise
Commonly Associated Conditions
Foot pronation, arch abnormalities (pes planus or cavus), plantar fasciitis
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Domino, Frank J., et al., editors. "Sever Syndrome." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816869/all/Sever_Syndrome.
Sever Syndrome. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816869/all/Sever_Syndrome. Accessed May 29, 2023.
Sever Syndrome. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816869/all/Sever_Syndrome
Sever Syndrome [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 May 29]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816869/all/Sever_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Sever Syndrome ID - 816869 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816869/all/Sever_Syndrome PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -