Sever’s Disease
Sever’s disease is one of the most common causes of heel pain in active children, and often the reason parents bring in a sporty child who’s suddenly started limping or avoiding activities they used to love.
At Emerald Hill Podiatry, we see this frequently during growth spurts, and our podiatrists help manage the pain so kids can stay active without making the underlying irritation worse.
What Is Sever's Disease?
Sever’s disease, medically known as calcaneal apophysitis, is a painful inflammation of the growth plate at the back of the heel bone, where the Achilles tendon attaches. Despite the name, it isn’t a true disease, it’s an overuse injury that occurs during periods of rapid growth, most commonly in physically active children between the ages of 8 and 14.
Why the Heel Hurts During Growth Spurts
During a growth spurt, bones tend to lengthen faster than the muscles and tendons around them can keep up. This mismatch leaves the calf muscles and Achilles tendon relatively tight, pulling more forcefully on the heel’s growth plate with every step, jump, or run. Because the growth plate is made of softer cartilage rather than mature bone, it’s more vulnerable to this repetitive tension, and the constant pulling leads to inflammation and pain.
The Age and Activity Profile
Sever’s disease typically affects children between 8 and 14 years old, slightly earlier in girls than boys, and becomes rare once the heel’s growth plate has fully matured, usually by around age 15. It’s especially common in children involved in running and jumping sports, such as football, basketball, gymnastics, and track and field, and can affect one or both heels at the same time.
The Pain Pattern
- Pain at the back or underside of the heel, often worse after activity rather than during it
- Pain that eases with rest and tends to flare up again once activity resumes
- Tenderness when the sides of the heel are squeezed
- A tendency to walk on tiptoes or with a limp to avoid heel pain
- Mild swelling or tightness in the Achilles tendon and calf
Watch this short video for a clear overview of what’s happening in the heel and why it’s more common during growth spurts: What Is Sever’s Disease (Heel Pain in Teenagers) and What Causes It?
When to See a Podiatrist
See a podiatrist if:
Heel pain is affecting your child's participation in sport or daily activity
The pain isn't improving with rest, or keeps returning once activity resumes
Your child is limping or walking on their toes to avoid heel pain
You'd like guidance on managing symptoms so your child can stay active without worsening the irritation
Get Your Sever's Disease Properly Assessed
Calming the Growing Heel
Because Sever’s disease resolves on its own once the growth plate matures, treatment focuses on easing pain and reducing strain on the heel in the meantime.
Options include:
- Activity Modification — adjusting training load or switching to lower-impact activities during flare-ups, without necessarily stopping sport altogether
- Stretching and Strengthening Program — calf and Achilles stretches to ease the tension pulling on the growth plate
- Custom Orthotics and Heel Cups — cushion and support the heel, reducing the pull of the Achilles tendon with each step
- Shockwave Therapy (ESWT) — supports recovery in cases where pain is persistent despite standard measures
What to Expect at Your Assessment
Your podiatrist examines your child’s heel, checks for tenderness with the squeeze test, and assesses calf and Achilles tightness alongside their gait. Because Sever’s disease is diagnosed clinically, imaging is rarely needed unless another cause of heel pain is suspected. From there, a plan is set to manage pain and keep your child comfortably active through the growth spurt.
