Sever’s Disease (kids heel pain)

What is Sever’s Disease?

Before you start to worry, rest assured. Sever’s disease is not an actual disease but a painful condition that will resolve. Clinically referred to as Calcaneal Apophysitis, Sever’s has often been referred to as ‘growing pains’, though this does not describe how and why the pain occurs. Sever’s is actually the abnormal tension (pull) on the heel bone and its growth plate in kids. Growth plates are located on the ends of growing bones and will eventually turn into solid bone when we reach full maturity. As we grow, our bones, muscles and tissues all grow and lengthen too. In Sever’s, the Achilles (which also connects to the calves) hasn’t elongated at the same rate that the heel bone has been growing, the resulting tension and pull on the back of the heel becomes very painful.

What are the symptoms?

Symptoms typically occur during a period of growth, particularly between 8-14 years and include:

• Pain at the back of the heel that can be sharp or aching
• Pain occurs during (or after) sports or physical activity
• Abnormal tightness through the back of the legs down to the heel
• Swelling at the back of the heel
• Pain that is reduced with rest and ice, but comes back with activity

What can trigger Sever’s pain?

Any additional factors that cause increased strain on the achilles/calves/heels can exacerbate this pain, including:

• Running sports
• Increased physical activity
• Soccer boots and low-heeled shoes
• Tight calf muscles
• Hard surfaces

How do you treat Sever’s?

They key is to not only settle the symptoms but treat the cause, that is, reduce the abnormal pull on the heel from the achilles. After using rest and ice to reduce the pain if it arises, treatment to eliminate Sever’s pain long-term may include the combination of:

• Orthotics - to keep the foot in its optimal position so that it minimises the tension placed on the achilles where it connects to the heel
• Stretching and strengthening - this will lengthen tight muscles so they can functionally normally with the other bones, joints and tissues. This also reduces the risk of further injury down the track
• Footwear check - this ensures that footwear isn’t worsening the foot pain. Even good, supportive shoes may have a low set heel which will place more tension on the achilles/heel

• Activity modification - your podiatrist will work with you to modify regular activities to reduce the tension and pain on your heel

While Sever’s is a frustrating, painful and upsetting condition, you don’t need to put up with it or wait months hoping that it will resolve. Your Podiatrist will get your little one back on the field and doing the things they love as quickly as possible.

To read about our Senior Podiatrist and Managing Director Troy Parsons and his battle with heel pain, click here: Growing Pain Explained - What's Going On?