Sever’s disease is a common cause of heel pain in active, growing children. It occurs when the growth plate at the back of the heel becomes irritated by repeated pulling and impact during a growth spurt.
Despite its name, Sever’s disease is not an infection or a disease that makes a child unwell. It is a growth-related condition, also known as calcaneal apophysitis, that usually improves as the heel bone finishes developing.
If your child is experiencing recurring heel pain, limping or avoiding sport, a children’s podiatrist on the Gold Coast can assess what is contributing to their symptoms and recommend an individual management plan.
What causes Sever’s disease?
Children’s bones, muscles and tendons do not always grow at the same rate. During a growth spurt, the heel bone may grow faster than the surrounding muscles and tendons can adapt.
This can increase tension through the calf muscles and Achilles tendon, which attach around the back of the heel. Running, jumping and repeated impact can then place additional stress on the developing growth plate.
Sever’s disease is particularly common in active children who participate in sports such as:
- Soccer
- Football
- Netball
- Basketball
- Gymnastics
- Athletics
- Tennis
- Dance
The condition can affect one or both heels. It may become more noticeable when training increases, a child begins a new sport or activity levels suddenly change.
What age does Sever’s disease affect?
Sever’s disease most commonly affects school-aged children during periods of rapid growth. It is often seen between approximately eight and fourteen years of age, although every child develops at a different rate.
Once the growth plate in the heel matures, Sever’s disease usually stops recurring. However, symptoms may come and go throughout a child’s growing years, particularly during busy sporting periods.
What are the symptoms of Sever’s disease?
The most common symptom is pain or tenderness around the back or underside of the heel. The discomfort is often worse during or after physical activity and generally improves with rest.
Parents may notice that their child:
- Complains of heel pain after running or sport
- Limps after training or a game
- Walks on their toes to avoid putting pressure on the heel
- Avoids activities they normally enjoy
- Has tenderness when the heel is gently pressed
- Feels stiff or sore when starting activity
- Struggles to keep up with teammates
- Has mild swelling around the heel
Children do not always explain pain clearly. Some may simply become less active, ask to be carried or begin avoiding particular shoes.
Is all heel pain in children caused by Sever’s disease?
No. Although Sever’s disease is a common cause of heel pain in growing children, it is not the only possible explanation.
Heel pain may also be associated with a recent injury, footwear pressure, changes in activity, muscle tightness or another foot and lower-limb condition. This is why it is important to have recurring pain properly assessed rather than assuming it is growing pain.
Seek prompt medical advice if your child is unable to place weight on the foot, has significant swelling or redness, develops a fever, appears unwell or has severe pain following an injury.
How does a podiatrist assess heel pain in children?
A podiatrist will ask when the pain began, which activities make it worse and whether there has been a recent change in sport, footwear or training.
The assessment may include:
- Identifying the exact location of the heel pain
- Checking the movement of the foot and ankle
- Assessing calf and Achilles tendon flexibility
- Observing how your child stands, walks or runs
- Reviewing their school and sporting shoes
- Looking at their recent activity and training load
- Checking for signs that may indicate another condition
Scans or X-rays are not normally required to identify Sever’s disease. However, further investigation may be recommended when the symptoms or assessment findings suggest another possible cause.
How is Sever’s disease managed?
Management depends on the severity of the heel pain, your child’s activities and what is contributing to the irritation.
Temporary activity changes
Your child may need to temporarily reduce running, jumping or other activities that aggravate the heel. This does not always mean stopping every form of exercise.
Lower-impact activities may be more comfortable while symptoms settle. Your child should not be encouraged to continue playing through pain that is causing them to limp or change the way they move.
Supportive footwear
Well-fitting shoes with appropriate cushioning and support can help reduce unnecessary pressure around the heel. Worn-out shoes, hard soles or sporting shoes with studs may make symptoms more noticeable for some children.
A podiatrist can review your child’s school and sporting footwear. The Foot Stop also provides professional footwear assessments on the Gold Coast.
Heel cushioning or support
Heel cushions, inserts or lifts may be considered to reduce strain and improve comfort. These should be selected according to your child’s symptoms and footwear rather than purchased without an assessment.
Some children may benefit from custom orthotics when foot function is contributing to repeated pressure. However, not every child with Sever’s disease requires orthotics.
Stretching and strengthening
An individual exercise program may help improve calf flexibility and support the muscles around the feet and ankles. Exercises should be appropriate for your child’s age, symptoms and stage of recovery.
Cold packs
A wrapped cold pack may help settle discomfort after activity. Never apply ice directly to the skin. Speak with your child’s healthcare professional about how and when to use cold therapy safely.
Can children return to sport after Sever’s disease?
Yes. Most children can gradually return to their usual sport as their symptoms improve.
A return to activity should be gradual. Your child should be able to walk, run and complete sport-specific movements comfortably without limping or significantly changing how they move.
If the heel pain returns, their activity may need to be adjusted again. A sports podiatrist on the Gold Coast can help plan a suitable return based on your child’s sport and symptoms.
Can a mobile podiatrist assess children’s heel pain?
Yes. The Foot Stop provides mobile podiatry across the Gold Coast and NSW, including Northern NSW and Sydney.
A mobile podiatrist can discuss your child’s symptoms, assess their feet and review their everyday footwear at home. If a more detailed walking, running or biomechanical assessment is recommended, our team can advise whether an appointment at the Elanora clinic would be more suitable.
Learn more about mobile podiatry on the Gold Coast or mobile podiatry in NSW.
Book a children’s podiatry assessment
Heel pain should not be dismissed if it keeps returning, affects your child’s walking or stops them from participating in activities they normally enjoy.
The Foot Stop provides children’s podiatry at our Elanora clinic and mobile podiatry across the Gold Coast, Northern NSW and Sydney.
Request an appointment with The Foot Stop if your child is experiencing recurring heel pain, limping or discomfort during sport.