If your child has ever come home after playing and complained, “My heel hurts,” it’s natural to be concerned.
For active kids between the ages of 8 and 14 and who love to run and jump, that heel pain could be a common condition known as Sever’s disease.
While the name might sound serious, it’s actually a normal part of growing for many children — and very treatable.
Here at the Chesapeake Foot And Ankle Institute, we’re podiatrists in Tysons, VA who specialize in diagnosing and treating pediatric foot conditions to help kids stay active and pain-free.
In this article, we’ll be taking a closer look at Sever’s disease in children.
We’ll look at what it is, how to tell if your child has it, and how a podiatrist can help play a role in treating it.
What Is Sever’s Disease?
Sever’s disease is a condition that causes heel pain in kids who are growing.
You might also hear it called calcaneal apophysitis.
That’s just a long, fancy name for the same thing.
It’s the main cause of heel pain in growing children.
Here’s something important to know: Sever’s disease is not really a disease.
It’s more like an injury or when something gets a little irritated and swollen in your child’s heel.
Think of it like when you bump your knee and it gets sore.
This soreness happens in a special part of your child’s heel bone called the growth plate.
Growth plates are like soft spots made of cartilage at the ends of your child’s bones.
These spots help them grow as they develop.
Once they finish growing, these growth plates turn into hard bone.
But while they’re still soft, they can be a little weaker than the strong parts around them, like tendons and ligaments.
Dr. James Warren Sever was the first doctor to tell people about this problem way back in 1912, so that’s why it’s called Sever’s disease.
It only happens to children and teenagers who still have their growth plates.
Why Do Some Kids Get Sever’s Disease?
When children grow, it’s not a steady process.
Instead, they’ll go through different periods of increased growth.
This is when their bones, muscles, and tendons all grow more quickly than usual.
We call these “growth spurts”.
But even during growth spurts, not everything is always even.
Sometimes, your child’s bones might grow faster than the muscles and tendons around them.
This can cause tightness in their tendons.
Now, think about all the running and jumping kids do.
When your child runs or jumps, it puts a lot of stress on their heels and the Achilles tendon.
The Achilles tendon is a strong cord that connects the muscles in the back of the leg (your calf muscles) to the heel bone.
Sometimes it can be confused with the plantar fascia which is a ligament that starts on the bottom of the heel and extends to the ball of the foot
Every time your child jumps, this tendon pulls on the growth plate in the back of the heel.
If this pulling happens over and over again, it can make that growth plate sore and swollen.
This is what we call Sever’s disease.
Some things can make it more likely for your child to get Sever’s disease:
- If they play sports where they run and jump a lot, like gymnastics, volleyball, basketball, soccer, or dance
- If they are overweight, because this puts more pressure on their heels
- If they wear shoes that don’t provide enough support for their activities
- If their foot rolls in too much when they walk, which doctors call a pronated foot
- If they have high arches or flat feet
- If they have a tight Achilles tendon
- If one leg is a little shorter than the other, called short leg syndrome
- If they like running and jumping a lot, especially on hard surfaces
How To Tell If Your Child Has Sever’s Disease?
The most common sign of Sever’s disease is pain in the back of the heel.
Your child might say it hurts when they walk, run, or jump.
The pain might get worse when they are active and feel better when they rest.
Here are some other things you might notice:
- If the bottom or sides of their heels are sore to the touch
- If there’s swelling, redness, or warmth around their heel
- If their feet feel stiff
- If they limp or walk on their toes, to keep their weight off their sore heel
- If they have trouble walking normally
- If squeezing both sides of their heel hurts
Sometimes, the pain can be in one heel or both heels.
Most kids say it hurts in both.
The pain can also sometimes go down the sides and bottom of the heel, around the arch of their foot.
Can Adults Have Sever’s Disease?
Short answer… no!
Sever’s disease affects the growth plates.
As a result, you can only get Sever’s disease before your growth plates have turned into bone.
That happens during puberty.
So once you’ve finished puberty, you can’t get Sever’s disease.
How Is Sever’s Disease Diagnosed?
If your child has heel pain, it’s always a good idea to take them to see a podiatrist.
Podiatrists are medical doctors that specialize in treating foot and ankle conditions.
Your podiatrist will ask you about your child’s symptoms and how active they are.
They will also do a physical exam.
This will include gently pushing on different parts of your child’s foot and heel to see where it hurts the most.
If your child has Sever’s disease, it will usually hurt when the doctor squeezes the sides of the heel.
Sometimes, your podiatrist might ask your child to walk, run, jump, or even walk on their heels to see if it makes the pain worse.
Usually, your podiatrist will be able to tell if it’s Sever’s disease just by doing these things.
But sometimes, they might want to take X‑rays or do an MRI.
However, X‑rays of a foot with Sever’s disease generally looks the same as a foot without it.
But it can help to make sure there isn’t something else causing the pain, like a stress fracture or a full fracture (broken bone).
What Should You Do If Your Child Has Sever’s Disease?
If your child does have Sever’s disease, your podiatrist can help.
The main goal of treating Sever’s disease is to help manage their pain and swelling.
Here are some ways your podiatrist can help.
1. Rest
Your child needs to take a break from activities that make their heel hurt, like running and jumping.
This could be for a few days or even a few weeks.
Your podiatrist will help you understand how much rest your child needs.
It’s important to start activities slowly again so the pain doesn’t come back.
If the pain is particularly bad, your podiatrist might suggest putting your child’s foot in a cast or a special boot (walker boot) for a little while to let the heel rest and heal.
2. Ice
Your podiatrist may recommend ice packs as well.
Do this a few times a day, for 15 – 20 minutes at a time.
Make sure to put a towel between the ice and their skin so it doesn’t get too cold.
3. Pain Relievers
If your child needs it, over the counter pain medication can help.
This includes ibuprofen, naproxen, or acetaminophen.
Unless your podiatrist says otherwise, never give your child aspirin.
4. Supportive Shoes
Your child may benefit from supportive footwear.
This can help support their arches and provide cushioning in the heel.
Sometimes, open-back shoes that don’t rub on your child’s heel can help.
You can also try heel pads or cushions in their shoes to help absorb the shock when they walk.
Shoes with a slightly elevated heel might also take some pressure off the growth plate.
Some kids might need custom shoe inserts as well.
That’s especially true for kids with chronic Sever’s disease.
These are special inserts made just for your child’s feet to help support them and take pressure off the heel.
Sometimes, a pediatric night brace can help to gently stretch your child’s calf and heel while they sleep.
Can My Child Still Play If They Have Sever’s Disease?
If your child’s heel is hurting, it’s a good idea to avoid too much athletic activity.
Your podiatrist will help you understand when it’s safe for them to go back to their activities.
Sometimes, they can still do low-impact activities like swimming or bike riding if it doesn’t hurt their heel.
Book Your Appointment With Our Podiatry Clinic Today
Remember, Sever’s disease is a common reason for heel pain in active kids who are growing.
It’s usually just temporary, and there are many things you can do to help your child feel better.
By understanding what Sever’s disease is, knowing the symptoms, and taking the right steps for treatment and prevention, you can help your child get back to doing the things they love.
At the Chesapeake Foot and Ankle Institute, we specialize in helping growing kids recover safely and comfortably.
We’re here to answer your questions and create a treatment plan tailored to your child’s needs.
Book your appointment with the Chesapeake Foot And Ankle Institute today to get started with an assessment for your child’s feet.
