If your child has started complaining about heel pain — particularly during football, running, gymnastics or other sports — it can be easy to put it down to “growing pains”.
But persistent heel pain in an active, growing child may be something called Sever’s disease.
Despite the name, Sever’s disease is not actually a disease. It is a common condition affecting the developing growth area at the back of the heel, and it tends to occur during periods of rapid growth.
What is Sever’s disease?
Sever’s disease, also known as calcaneal apophysitis, affects the growth plate at the back of the heel bone.
During a growth spurt, bones, muscles and tendons do not always develop at exactly the same rate. The calf muscles and Achilles tendon can become relatively tight and place increased pulling force through the developing heel.
Add running, jumping, football training or other repetitive activity, and that area can become irritated and painful.
It is particularly common in active children around the pre-teen and early teenage years and often becomes more noticeable during periods of increased sport or training.
What does Sever’s disease feel like?
Children with Sever’s may complain of:
- Pain at the back or sides of the heel
- Heel pain during or after sport
- Pain with running or jumping
- Limping after activity
- Walking on their toes to avoid putting pressure through the heel
- Tightness through the calves or Achilles tendon
- Pain that settles with rest but returns when activity increases
Because there are other causes of heel pain in children, it is important to have persistent or significant heel pain properly assessed rather than simply assuming it is Sever’s disease.
How may Foot Mobilisation Therapy help?
At Advanced Podiatry Solutions, we look beyond just the painful area.
With Sever’s-related heel pain, we assess how the foot and ankle are moving, calf and Achilles flexibility, walking and running mechanics, footwear, activity levels and other factors that may be increasing load through the heel.
Foot Mobilisation Therapy (FMT) may form part of the plan where we identify restrictions or tightness in the foot and lower limb.
FMT is a hands-on approach that aims to:
- Improve mobility through restricted joints in the foot and ankle
- Address surrounding soft tissue tightness
- Support more comfortable movement
- Help the foot and lower limb move more effectively
- Work alongside targeted exercises and activity management
FMT does not change the growth plate itself. Rather, our aim is to address movement and loading factors around the foot and lower limb that may be contributing to the child’s symptoms.
What we have seen in the clinic
We have seen many children with Sever’s-related heel pain, particularly active kids involved in football, running, gymnastics and other sports.
One of the most common things parents tell us is that they have been left feeling discouraged. Some have been told their child simply needs to stop sport completely, wait until they grow out of it, or that they may not be able to keep doing the activities they love.
For a child who loves their sport, that can be incredibly disheartening — and stressful for parents too.
There are certainly times when reducing or temporarily modifying activity is appropriate. But that does not automatically mean every child needs to stop everything they enjoy.
At Advanced Podiatry Solutions, we look at the individual child. We assess their foot and ankle movement, calf and Achilles flexibility, footwear, sporting load and other factors that may be contributing to the stress through the heel.
We have had very encouraging results with children experiencing Sever’s-related heel pain, particularly when hands-on care is combined with appropriate exercises, footwear advice and sensible management of their activity.
Our aim is to find a balance between allowing the irritated area to settle and helping the child stay involved in the activities they enjoy where it is appropriate to do so.
Rather than simply saying “stop sport”, we look at questions such as:
- What movements or activities are aggravating the heel?
- How much training is the child currently doing?
- Are there restrictions or tightness through the foot, ankle or calf?
- Is their footwear appropriate for their sport?
- Can their activity be modified rather than stopped completely?
- What can we do to help them gradually build back toward full participation?
Every child is different, and there is no one-size-fits-all approach. But heel pain during growth does not necessarily mean giving up the sport they love.
If your child has been told they simply have to “wait it out” and they are still struggling with pain, we encourage you to have them assessed and explore what options may be available to help them move more comfortably.
What else may help?
Management for Sever’s disease may include:
Activity modification — temporarily reducing or changing the activities that are aggravating the heel rather than repeatedly pushing through significant pain.
Calf and Achilles exercises — stretching and appropriate exercises may help reduce tension around the developing heel.
Heel cushioning or support — heel cups or pads may help reduce discomfort and load through the heel, particularly in sports footwear.
Footwear advice — making sure your child has footwear appropriate for their sport, foot and current symptoms.
Gradual return to sport — as symptoms improve, activity can usually be built back up progressively rather than going from complete rest straight back into full training.
Should children simply grow out of it?
Sever’s disease is associated with the developing growth plate and eventually resolves once this area matures. However, that does not mean a child needs to spend months struggling with heel pain while waiting to grow out of it.
If heel pain is affecting sport, causing your child to limp, repeatedly returning or limiting normal activity, an assessment can help identify what may be contributing and what can be done to make them more comfortable.
Is your child struggling with heel pain?
If your child is regularly complaining about sore heels, avoiding sport or limping after activity, we recommend having it assessed.
Our Takapuna podiatrists can assess their feet, ankles, movement, footwear and activity levels and put together an individual plan to help them move more comfortably and get back to the activities they enjoy.
Book an appointment with Advanced Podiatry Solutions today to have your child’s heel pain assessed by an expert podiatrist.
Need help with a foot or lower limb issue?
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