Sever’s Disease: What You Need to Know About Your Child’s Heel Pain

Jan 28, 2022

Children experience many unexplained and random aches and pains as their bones and muscles grow. Most can be treated with mild pain relievers and some TLC. Others require a little more attention to treat properly.

One such growing pain is Sever’s disease. Even though “disease” is in its name, it is not contagious like a virus or bacteria. Sever’s disease is a pain in a specific spot on one or both feet and commonly occurs in children ages 8-15. While it is not serious, it is a condition that should be treated quickly to prevent further pain and discomfort and to get your child up and running quickly and safely.

What is Sever’s Disease?

Sever’s disease (also known as calcaneal apophysitis) is identified by heel pain due to swelling and inflammation of the growth plate in the heel. The growth plate is a section of cartilage at the end of a bone, where most of the bone’s growth takes place. The growth plate in any bone is weaker and more at risk of injury than the rest of the bone.

Specifically, Sever’s disease is caused by repetitive stress and strenuous activities. The pain is located where the Achilles tendon attaches to the back of the heel. In addition to active kiddos, Sever’s disease also is most likely to happen during growth spurts.

Frequent causes of Sever’s disease in children:

  • Repetitive activities that place significant stress on the feet.
  • Running and jumping on hard surfaces (track, basketball, gymnastics, volleyball, etc.).
  • Overexertion and training.
  • Shoes that do not properly support your child’s feet.
  • Though not as common, standing in one position for long periods can cause Sever’s disease.
child's heel pain

How Serious is Sever’s Disease?

While painful and bothersome, it is not a serious condition, and it is quite common. Additionally, Sever’s disease will not cause long-term damage and usually resolves after careful treatment. 

What are the Signs and Symptoms of Sever’s Disease?

Every case of Sever’s disease presents with heel pain in one or both feet. While there are many causes for heel pain, look for these indications in your child to help determine if they might be suffering from it:

  • Pain and tenderness in the back of the heel can also cause pain on the sides and bottom of the heel.
  • Pain that gets worse with strenuous activities.
  • Is your child limping or “favoring” one of their feet?
  • Walking on toes to reduce weight and strain on heels.
  • Increased pain from activities like jumping or running.
  • Tenderness when pressure is applied to the back of the heel.
  • Swelling and/or redness in the heel area.
  • Increased heel pain and stiffness upon waking or after periods of inactivity.

Diagnosis of Sever’s disease is a straightforward process where we:

  • Examine your child’s foot.
  • Apply pressure in different areas to pinpoint the location of the pain.
  • Talk with them about when it started, what makes it worse, and how persistent the pain is for them. 

Sever’s disease will not show on an X-ray, but in some cases, we may order one of your child’s feet to rule out fractures or other possible issues.

child's heel pain

How Long Does the Pain from Sever’s Disease Last?

With proper rest and care, the pain from Sever’s disease usually subsides in about two weeks. But the only “cure” for Sever’s disease is to stop growing. Once your child has been diagnosed, treated, and is pain-free, and they are still growing, there is no guarantee that it will not happen again. As long as their growth plates remain pliable during development, children will be susceptible to Sever’s disease.

How is Sever’s Disease Treated?

If your child suddenly presents with heel pain, the best thing you can do is reduce and limit their activity. Walking and non-weight-bearing activities, like swimming, are acceptable if it is not causing increased pain.

The most effective treatments for Sever’s disease are:

  • RICE (Rest, Ice, Compression, Elevate)
    • Have your child rest their feet as much as possible, which means taking a break from sports and strenuous exercise while the growth plate heals
    • Ice their feet every few hours for about 15 minutes
    • Use an elastic wrap or compression socks to help reduce pain and swelling
    • Elevate their feet above their heart, which helps manage  the swelling
  • Ibuprofen and acetaminophen will help control the pain (follow the dosing instructions on the package for your child’s age and weight).
  • Have your child wear shoes that have ample cushioning and provide plenty of support through the heel.
  • Use heel support cups or gel inserts in their shoes to help reduce stress on the heel.
  • Wearing a walking boot that restricts foot and ankle movement helps to expedite healing and prevent further injury as they are healing from an episode of Sever’s disease.
  • Stretching is helpful when your child is suffering from Sever’s and continued stretching after healing will help prevent it. Focus on stretching the calf muscles to “loosen” the Achilles tendon and strengthen leg muscles.
  • Physical therapy can be a tremendous help in overcoming the pain of Sever’s disease. It also has the added benefit of learning how to stretch and strengthen the leg muscles to prevent it from happening again.

When Should My Child See a Doctor for Sever’s Disease?

In most cases, Sever’s disease can be treated with the suggestions mentioned above. However, we strongly encourage you to contact us if the pain is severe or does not go away with rest. Contact us immediately if you observe swelling or redness on or near the heel, or if you know your child has sustained an injury to the area.

If you are concerned that your child’s heel pain associated with Sever’s disease, or the pain is not diminishing after following the suggestions outlined above, contact us as soon as possible. At Michigan Foot & Ankle Specialists, we can assess the symptoms your child is experiencing, and discuss what treatment is best for them to get them back to their normal activities. Schedule an appointment with our Dearborn office by calling (313) 582-6222 or by filling out our online contact form.

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