Sever’s Disease

The leading cause of heel pain in children and teenagers

Sever’s Disease (Calcaneal Apophysitis) is one of the most common causes of heel pain in children treated at Advance Foot Clinic. It typically affects children aged 8-14 years, largely due to the rapid growth changes experienced during this stage. Both boys and girls are equally impacted, with active children being most prone to developing Sever’s Disease.

What is Sever’s Disease?

Sever’s Disease is most commonly characterised by activity-related pain at the back of the heel, where the Achilles tendon attaches. It is an inflammation of the growth plate in the heel (calcaneus), often caused by repetitive stress, especially during growth spurts when heel bones, tendons, and muscles rapidly develop. Swelling and tenderness may also occur in the affected area. Foot pain is common in children who play sports involving running, jumping, or high-impact activities, such as football, basketball, and gymnastics.

Children with Sever’s Disease typically experience pain in one or both heels, especially after physical activity. They may also develop a limp and avoid movements that strain and contribute to tight Achilles tendons, such as jumping, hopping, or walking up and down stairs. In some cases, children may walk on their toes, which can be mistaken for Sever’s Disease, though this usually doesn’t involve heel pain.

Explore our blog, Foot Pain in Children, and discover common complaints and their causes.

graphic showing inflammation of the growth plate on a heel bone, illustrating Server's Disease

Symptoms of Sever's Disease

Sever’s Disease typically causes various symptoms that impact a child’s daily activities. The severity of these symptoms can vary, but they generally result in discomfort and limitations, especially during or after physical activity. Here are the most common signs to look out for:

  • Pain: The most common symptom is pain at the back of the heel, especially during or after physical activity. The pain can range from mild to severe and is often worsened by running, jumping, or other high-impact movements.
  • Swelling: Swelling may develop around the heel, particularly where the Achilles tendon attaches to the growth plate. This swelling can make the area feel tender and inflamed.
  • Stiff feet and ankles: Stiffness in the feet and ankles is common, especially after long rest periods or in the morning. This can make it difficult for children to move their feet freely.
  • Limping: Due to the pain and discomfort, children with Sever’s Disease may develop a limp or alter their walking pattern to avoid putting pressure on the affected heel.

If your child has any of these symptoms, it’s best to contact Advance Foot Clinic. Our kids’ sports podiatry experts will rule out other conditions, such as stress fractures, tendonitis, or injury, and provide an accurate diagnosis of Sever’s Disease.

Causes and contributing factors

Sever’s Disease most commonly affects children between the ages of 8 and 14 during rapid growth periods. Several factors can contribute to the development of this condition:

  • Age: It typically occurs in children aged 8 to 14, when bones, tendons, and muscles grow and change.
  • High-impact activities: Sports like football, basketball, and gymnastics, which involve running, jumping, and sudden movements, increase stress on the heel.
  • Increased activity levels: A sudden increase in physical activity or training can strain the heel excessively, particularly during growth spurts.
  • Excessive pronation (rolled-in feet): When the feet roll inward too much during movement, it alters foot mechanics and places added stress on the Achilles tendon, calf muscle and heel, contributing to inflammation.

Sever's Disease Treatment at Advance Foot Clinic

At Advance Foot Clinic, we provide a comprehensive approach to treating Sever’s Disease. Our treatment plan is tailored to your child’s specific needs, and typically includes:

  • Assessment and diagnosis: We begin with a thorough assessment to understand the issue and accurately diagnose Sever’s Disease, ruling out other potential conditions.
  • Footwear advice: We offer expert advice on the best footwear for school and sports shoes, ensuring they provide the right support for your child’s feet.
  • Padding and Orthotics: Formthotics and custom orthotics may be recommended to reduce pain and pressure on the affected area and enhance comfort.
  • Strapping: We may use foot, ankle, or knee strapping to provide extra support and stability during physical activity.
  • Pain management advice: Our team offers guidance to relieve pain, including appropriate rest and other methods to help reduce discomfort.
  • Long-term treatment: We aim to relieve pressure on the growth plate and initiate a strengthening program to ensure ongoing recovery and prevent future issues.

We’re committed to providing your child with a treatment plan that addresses the symptoms and supports long-term foot health, allowing them to get back to doing what they do best — running, playing, and enjoying sports.

Steps to take during a Sever's Disease flare-up

When flare-ups occur, there are several steps you can take to help manage your child’s symptoms:

  • Reduce or modify current activities: Limit activities that strain the heel, such as running or jumping, to avoid further irritation.
  • Stretching exercises and massages: Gently stretch the Achilles tendon and massage the heel and growth plate to relieve tension, but avoid applying pressure that causes pain.
  • RICE – Rest, ice, compression, & elevation: Use the RICE method to reduce inflammation and support recovery. Ensure your child gets plenty of rest, applies ice or cold packs to the affected area, uses compression to reduce swelling, and elevates the foot when possible.

If flare-ups persist despite following these tips, we recommend booking an appointment with one of our podiatrists to rule out any injuries that may require medical intervention.

Your trusted partner for foot health

Why choose Advance Foot Clinic Podiatry

Five convenient locations

With four locations across Brisbane's north-western suburbs and a dedicated podiatrist in Mount Isa, we are conveniently positioned to serve our community.

Comprehensive care

From diagnosing and treating conditions like Sever’s disease to offering preventive education, we provide a full spectrum of care to ensure long-term foot health.

People-centred approach

We listen carefully to your concerns and tailor our services to create treatment plans focusing on your recovery and well-being.

Personalised treatment plans

Our podiatrists design custom treatment plans based on your condition and lifestyle, using a variety of therapies to help you live pain-free.

Experienced, qualified podiatrists

Our professional podiatrists deliver high-quality care, staying up-to-date with the latest treatments to address all foot and ankle concerns.

Advanced technology

We use cutting-edge technology for precise diagnoses and effective treatments, ensuring better outcomes and faster relief from conditions like Sever’s disease.

Frequently asked questions

You can take steps to alleviate pain and discomfort, and when symptoms are mild or temporary, medical intervention may not be necessary. However, it is important to be proactive and monitor your child’s symptoms closely. Sever’s Disease, treated with a personalised treatment plan, helps children recover faster, so we recommend consulting a podiatrist for the best care.

Sever’s Disease is diagnosed through a physical examination and a review of your child’s medical history. A podiatrist will assess the heel for tenderness, swelling, and pain, particularly around the Achilles tendon attachment. X-rays or other imaging tests may rule out other conditions or confirm the diagnosis if needed.

Sever’s Disease is often difficult to prevent due to its connection with growth spurts. However, wearing sports shoes with good arch support, using supportive shoe inserts, and limiting high-impact activities can reduce the risk. Regular stretching and a strengthening program for the lower legs can also help prevent strain and promote overall foot health.

If your child’s symptoms persist or worsen despite following recommended care at home, it’s best to consult a podiatrist. They can provide a thorough assessment and offer treatment options. You may also want to check in with your child’s doctor for additional guidance for further relief if your child is experiencing severe pain.

Take the first step towards happy and healthy feet.

Ready to give your feet the care they deserve? Book your appointment online or call us and experience our expert podiatry services at any of our clinic locations.