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The heel bone grows faster than the ligaments in the leg. As a result, muscles and tendons can become very tight and overstretched in children who are going through growth spurts. The heel is especially susceptible to injury since the foot is one of the first parts of the body to grow to full size and the heel area is not very flexible. Sever’s disease occurs as a result of repetitive stress on the Achilles tendon. Over time, this constant pressure on the already tight heel cord can damage the growth plate, causing pain and inflammation.
Such stress and pressure can result from:
• Sports that involve running and jumping on hard surfaces (track, basketball and gymnastics).
• Standing too long, which puts constant pressure on the heel.
• Poor-fitting shoes that don’t provide enough support or padding for the feet.
• Overuse or exercising too much can also cause Sever’s disease.
Sever’s disease is most likely to occur during the growth spurt that occurs in adolescence. For girls, growth spurts usually occurs between 8 and 13 years of age. For boys, it’s typically between 10 and 15 years of age.
The back of the heel hardens and becomes stronger when it finishes growing, which is why Sever’s rarely occurs in older adolescents and teenagers.
The most common symptoms of Sever’s involves pain or tenderness in one or both heels. This pain usually occurs at the back of the heel, but can also extend to the sides and bottom of the heel.
A child with Sever’s may also have these common problems:
• Heel pain with limping, especially after running.
• Difficulty walking
• Discomfort or stiffness in the feet upon awaking
• Swelling and redness in the heel
Symptoms are usually worse during or after activity and get better with rest.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”