Severs Disease – Heel pain in children

Is your child suffering from heel pain? Also known as calconeal apophysitis is a common cause of heel pain in growing children and teenagers. This causes inflammation at the growth plate of the heel, making movement particularly painful. 

What’s a growth plate?

As we grow and develop into an adult our bones are not full formed, they have a special area near the ends of bone composed of mostly cartilage, this gap is where most bone growth occurs, on an X-ray, the growth plate will look similar to a broken bone. 

Until these areas are fully developed, they are more susceptible to tendon and ligament damage. 

How does the injury occur?

Similar to other growth conditions like Osgood Schlatter’s (click here to find out more) It is primarily caused by repetitive stress to the heel, this is exacerbated in times of rapid growth. Movements such as jumping, sprinting, hopping and changing directions are common stressors for the pain, and unfortunately these are seen in most team and individual sports that children play. 

  • Basketball
  • Football
  • Netball
  • Soccer 
  • Volleyball
  • Athletics 

Severs can also happen in people who are less active also, this can be brought on by wearing a lot of flat shoes. 


  • Heel pain first a foremost, this pain would then be aggravated by activity, especially running and jumping
  • The heel pain can be up close to the achilles, or just underneath the heel, but also everywhere in between 
  • There is often swelling of the heel or the lower portion of the achilles tendon. 

Treatment of Sever’s

  • Primarily the treatment will be focused on reducing pain and inflammation as quickly as possible. This may involve reducing or altering the activity level of the child until the exercise becomes tolerable again. This will depend greatly on level of pain and discomfort 
  • A simple yet effective rehabilitation program will be implemented to improve strength and stability of not only the ankle but the lower limb as a whole 
  • This will be supplemented with hands on therapy in the clinic
  • Depending on pain levels and how much impact it is having on daily activities, other modalities might be considered, such as 
  • Heel cups or wedges to elevate the heel
  • Stretching exercises
  • Non steroid anti-inflammatories such as nurofen can help. 

Can I still be active with the heel pain?

Being active without pain is a crucial part of the rehabilitation process as well need to keep strong and mobile, therefore full rest from sport and activity is rarely required. It is most likely that you will need to decrease the number of sports you play, or the number of nights you train to allow adequate recovery. This will all be judged on the individual case. 

Will I recover?

Due to Severs being a growth disorder it’s not uncommon for the pain to re-occur in the coming years especially with growth spurts. We will cover management strategies to help deal with any possible future flare ups, maintaining a strong exercise regime can help prevent future occurrences. Click here to book now 


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