Your child used to bound out of the car and race to practice. Now they are limping, rubbing the back of one heel, and asking to sit out. It is hard to watch an energetic kid slow down, and it is natural to worry. The good news is that one of the most common causes of heel pain in growing athletes, Sever's disease, is temporary and usually responds well to simple, consistent care.
What Is Sever's Disease?
Despite its name, Sever's disease (calcaneal apophysitis) is not a true disease. It is an overuse injury of the growth plate in the heel bone. In children, the back of the heel contains a plate of developing cartilage that has not yet turned into solid bone. The Achilles tendon and calf muscles pull on this area, and repeated stress can leave it irritated and painful.
Because the condition is tied to growth, it goes away once the growth plate matures and fuses, typically in the mid-teen years.
Who Is Most Likely to Get It?
Sever's disease most often appears between about ages 8 and 14, during growth spurts. Bones can grow faster than the muscles and tendons around them, which leaves the calf tight and increases tension on the heel. It affects both boys and girls.
Kids who play sports involving running and jumping are especially prone, including soccer, basketball, gymnastics, track, football, and dance. Hard playing surfaces, cleats with little cushioning, and a sudden jump in training can all add to the load.
Signs and Symptoms to Watch For
Children may not describe their pain clearly, so watch how they move. Common signs include:
- • Pain or tenderness at the back or bottom of the heel
- • Pain that worsens during or after activity and eases with rest
- • Limping, or walking on tiptoes to avoid heel pressure
- • Tenderness when the sides of the heel are squeezed
- • Stiffness in the heel first thing in the morning
Pain can occur in one or both heels.
Why Evaluation Matters
Not every sore heel is Sever's disease. Stress fractures, Achilles tendon problems, and other conditions can cause similar pain, and they are treated differently. A foot and ankle evaluation typically involves a history, a physical exam of the heel and calf, and a look at how your child walks and runs. Imaging is not always needed, but may be used to rule out other causes when the picture is unclear.
Clinical guidance generally supports activity modification and conservative care as first-line management. Pushing through the pain rarely helps and can prolong the problem.
Practical Ways to Ease Heel Pain
Most children improve with conservative steps. These general tips are commonly recommended:
- Reduce running and jumping activities for a period, rather than stopping all movement
- Apply ice to the back of the heel for 15 to 20 minutes after activity
- Choose supportive athletic shoes and replace worn-out pairs
- Ask about heel cups or cushioned inserts to absorb shock
- Gently stretch the calf muscles each day, as advised by your physician
- Avoid barefoot walking on hard surfaces while the heel is sore
Symptoms often settle over a few weeks to a few months, though they can return during later growth spurts. Your child can usually return to full play gradually as comfort allows.
When to Seek Professional Help
See a foot and ankle specialist if heel pain lasts more than a couple of weeks, keeps your child from sports or daily activity, causes night pain, or follows a fall or injury. Swelling, redness, or fever alongside heel pain also deserves prompt attention.
At Ascend Foot & Ankle Center in Lafayette, Colorado, Deann Hofer Ogilvie, DPM, can evaluate your child's heel pain and help you build a plan to get them back to the activities they love. Call (303) 537-4714 to reach the office, open Monday through Friday, 9am to 3pm.