Sever’s Disease

Sever’s disease, also known as calcaneal apophysitis, is one of the most common causes of heel pain in children. We regularly see it at My Family Podiatry in Albany Creek, particularly in active kids who play sport several times per week.

It most commonly affects children between the ages of 8 and 14 and usually presents as heel pain during or after sport. The pain can range from a mild ache through to sharp discomfort that limits running, jumping, or even walking. While the name can sound worrying, Sever’s disease is a temporary growth-related condition and is very manageable with the right approach.

Early assessment and treatment can help your child stay active while reducing pain and preventing flare-ups.

What Is Sever’s Disease?

Sever’s disease occurs when the growth plate at the back of the heel bone becomes irritated and inflamed. This growth plate, known as the calcaneal apophysis, is made of softer cartilage and is more vulnerable to stress during periods of rapid growth.

As children grow, the bones of the legs can lengthen faster than the muscles and tendons. This creates increased tension through the Achilles tendon, which attaches directly onto the heel bone. With repeated running and jumping, the Achilles pulls on the growth plate, leading to pain and inflammation.

This is why children often complain of heel pain during sport or shortly afterwards, and why symptoms tend to worsen during growth spurts.

Factors That Can Make Sever’s Disease Worse

Several factors can increase the likelihood or severity of Sever’s disease.

Calf Muscle Tightness

During growth spurts, calf muscles often become tight. Tight calves increase the pulling force of the Achilles tendon on the heel bone, which places additional stress on the growth plate.

Foot Posture

Children with flatter feet may place more strain through the Achilles tendon due to altered foot mechanics. High arched feet can also contribute by reducing shock absorption during running and jumping.

High Impact Sport

Sports that involve sprinting, jumping, and sudden changes of direction place repeated stress on the heel. Basketball, soccer, gymnastics, athletics, netball, and football are common triggers.

Training Load

A sudden increase in training frequency, intensity, or duration can overload the heel before the body has time to adapt. This is common at the start of a new season or when children move into more competitive levels of sport.

How Common Is Sever’s Disease?

Sever’s disease is the most common cause of heel pain in children. We see it frequently in North Brisbane, particularly in Albany Creek and surrounding suburbs where many children are involved in organised sport year-round.

It is especially common in children who train multiple times per week, play on hard surfaces, or are going through a rapid growth phase.

How We Treat Sever’s Disease at My Family Podiatry

The good news is that Sever’s disease does not cause permanent damage. The challenge is managing pain until the growth plate matures and symptoms settle.

Treatment focuses on reducing load through the heel while maintaining as much activity as possible.

Custom Foot Orthotics

Orthotics are often used to reduce strain on the Achilles tendon and heel growth plate. This may include arch support and a heel raise to decrease tension through the calf and Achilles. Orthotics are customised based on your child’s foot posture, activity level, and footwear.

Shockwave Therapy

Shockwave therapy may be used in cases where pain is persistent or limiting participation in sport. It is a non invasive treatment that helps reduce pain sensitivity and stimulate tissue recovery around the Achilles and heel.

Calf and Achilles Management

Hands on treatment such as massage may be used to reduce calf tightness. Once pain settles, a structured stretching and strengthening program is introduced to improve flexibility and reduce recurrence.

Load Modification

Temporary adjustments to training volume, frequency, or intensity may be required. This does not always mean stopping sport completely, but rather modifying activities to keep pain manageable.

Ice and Pain Relief

Applying ice after sport can help reduce pain. Oral anti inflammatory medication may be appropriate in some cases, but this should always be discussed with your GP first.

Tips To Prevent Sever’s Disease

• Supportive Shoes: Ensure your child wears shoes that provide proper arch support, cushioning, and a snug fit. Avoid shoes that are too tight or lack support, especially during sports.

• Sport-Specific Footwear: If your child is involved in a particular sport, invest in shoes designed specifically for that activity. For example, soccer cleats for soccer or basketball shoes for basketball. These are tailored to protect the feet against the common strains of the sport. If required, a heel raise can be added to these shoes to reduce load on the calf muscle and reduce the likelihood of developing Sever’s disease.

• Daily Stretches: Encourage your child to stretch their calf muscles and Achilles tendon daily, especially before and after physical activities. Regular stretching can help maintain flexibility and reduce tension.

• Warm-Ups: Before engaging in sports or intense physical activity, a proper warm-up session can prepare the muscles and tendons, reducing the risk of injuries.

When to Seek Help

If your child has heel pain that:

• Persists for more than a few weeks

• Worsens with sport

• Causes limping or avoidance of activity

It is worth having them assessed by a podiatrist. Early intervention often means faster pain relief and fewer interruptions to sport.

Frequently Asked Questions About Sever’s Disease

Is Sever’s disease permanent?

No. Sever’s disease is a temporary condition related to growth. Symptoms usually resolve once the growth plate matures.

Should my child stop sport completely?

Not always. Many children can continue modified activity with the right treatment and load management.

Can orthotics help Sever’s disease?

Yes. Orthotics are commonly used to reduce strain on the Achilles tendon and heel growth plate.

Is shockwave therapy safe for children?

When clinically indicated and applied appropriately, shockwave therapy can be a safe and effective option for managing pain. This is not applied to the heel bone or growth plate but may be used on the calf muscle.

Does Sever’s disease affect one or both heels?

It can affect one heel or both, depending on activity levels and biomechanics.

If heel pain is affecting your child’s ability to enjoy sports and you are concerned it may be Sever’s disease, contact My Family Podiatry to discuss how we can help. Call 07 3088 6116 for more information or click the button below to book an appointment!

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