What is Sever's?

Severs Disease Final
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Sever’s (calcaneal apophysitis) is irritation of the growing area in the back of the heel. Growth plates are located throughout a growing child’s body allowing them to grow and become taller. These areas are made up of cartilage and are more vulnerable to injury.

Why does it happen?
Heel pain related to Sever’s can happen for a few reasons. Sometimes kids will jump or fall on the heel causing the pain to come on. Other times it can come on gradually after playing lots of sports. Pounding on hard surfaces from running can lead to irritation. Sometimes shoes with little padding (cleats for example) can make the pain worse. Tightness of the Achilles tendon (which attaches to the heel) can pull on the growing area, making the foot and ankle sore.

How do you know if your child as Sever's?
Your child will likely complain of pain in one or both heels after running or participating in sports. Sports where cleats are worn often make it worse. Your child may even limp at times if the pain becomes severe.

How is it diagnosed?
Your doctor will examine the foot and ankle area. X-rays are often ordered to evaluate the growth plate in the back of the heel. In Sever’s, X-rays are normal.

Can my child keep participating in sports?
Your child should not participate in their sport if he or she is seen limping during physical activity. They should rest from these activities and focus on icing and stretching. If your child experiences pain while at rest or with simple walking, contact their pediatrician. Occasionally immobilization in a boot is needed to calm the irritation in the growth plate.

What is the treatment for Sever's Disease?

  1. Heel cups: Rubber heel cups should be worn in all of your child’s shoes, especially in cleats. They can be changed out and switched between shoes.
  2. Icing: Your child should ice his or her heels after all sports activities. He or she can also ice when sore for 15 minutes at a time.
  3. Stretching: Keeping the calf and Achilles flexible is extremely important. Download our flyer for thee stretches you can use.


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