Sever's Disease

Sever’s disease is the most common cause of heel pain in growing children, especially those who play sports or exercise regularly. Also known as calcaneal apophysitis, Sever’s disease occurs when the growth plate in the back of the heel becomes inflamed and painful.

Sever’s disease most often affects children during adolescent growth spurts. In girls, growth spurts typically occur between the ages of 8 and 13. Boys typically have growth spurts when they’re between 10 and 15 years old.

Sever’s disease is rare in older teens. By late adolescence, a child’s growth plates have hardened into solid bone, and their muscles and tendons have lengthened to match the growth of their bones.

Athletes who participate in high-impact sports are at higher risk of developing Sever’s disease. Less active kids can also be affected, however.

Sever’s disease is caused by repetitive stress on the growth plate at the heel bone, at the site where the Achilles tendon pulls on the back of the heel. It typically occurs during periods of rapid growth.

The most common symptom of Sever’s disease is pain or tenderness in the back of one or both of the heels. The pain usually occurs at the back of the heel, but it can also extend to the sides and bottom of the heel.

If your child has Sever’s disease, their symptoms may include:

• Heel pain with limping, especially after running
• Swelling and redness around the heel
• Foot discomfort or stiffness after sleeping

Your child’s doctor will gather information about your child’s symptoms. They will also examine your child’s foot, squeezing it at different points to see where it is painful.

The doctor may also order an X-ray to rule out other problems, such as a fracture.

The primary treatment for Sever’s disease is taking time off from intense activities that cause heel pain. Stretching the calf muscles can help reduce the stress on the heel.

During the healing period, your child’s doctor may also recommend:

• Physical therapy to stretch the calf muscle and strengthen the leg muscles and tendons
• Placing ice or cold packs on your child’s heel
• Over-the-counter medication such as Tylenol or Motrin to reduce swelling
• Heel cup inserts that cushion the heel

The Orthopedics and Sports Medicine Department at Boston Children’s treats thousands of children, adolescents, and young adults with Sever’s disease and other problems of the musculoskeletal system every year.

Experts in our Lower Extremity Program offer comprehensive assessment, diagnosis, and treatment for children with lower limb conditions and have extensive experience treating complex disorders of the feet, ankles, knees, legs, and hips.

Our specialists in the Sports Medicine Division combine their knowledge of sports injuries and orthopedic care to help athletes return to play as strong or stronger than they were before.