In a perfectly functioning foot, when the heel strikes the ground, the growth plate that is sandwiched between two bony ends of the heel bone is compressed evenly across the whole surface. When the foot rolls in excessively (pronates), the bone is compressed on an angle that causes a shearing stress across the cartilage plate. This causes it to become inflamed, painful and to swell within its very tight space. This can create a serious problem because the end piece of bone is only supplied with blood vessels from the main body of the bone and these pass through the cartilage plate. If the cartilage swells too much, it can close off these vessels and result in a complication called avascular necrosis. This is a Latin term meaning tissue death due to lack of blood supply. As this is a growing child, the bone can repair without too much long term damage but it will be painful for an extended period usually about two years. Obviously, this is to be avoided as no active child wants to suffer pain nor be forced to sit out of sport for two years.
To see a printable page, browse to our Sever’s Disease Info Sheet. To learn more about childhood pain, see our Growing Pains Info Sheet. Alternatively, use this link to return to the Podiatry FAQs Blog.