Heel pain in kids can be more than just a temporary ache — especially when it becomes a recurring issue after sports, running, or other physical activity. One of the most common causes of heel pain in children and adolescents is Sever’s Disease, also known as calcaneal apophysitis. Despite its name, Sever’s Disease isn’t a disease in the traditional sense, but rather an overuse injury that affects the growth plate in the heel.
Understanding who’s at risk for Sever’s Disease can help parents take steps to recognize the early signs and seek proper care. When caught early and treated correctly, most kids recover quickly and get back to doing what they love — pain-free.
What Is Sever’s Disease?
Sever’s Disease is an inflammation of the growth plate in the heel bone (calcaneus). During childhood and adolescence, the bones are still growing. In the heel, there's a growth plate located at the back where the Achilles tendon attaches. When a child goes through a growth spurt, the heel bone can grow faster than the surrounding muscles and tendons, creating tension and leading to pain or inflammation at this sensitive area.
The condition typically occurs in physically active children between the ages of 8 and 14, and it tends to flare up during or after sports or intense physical activity. Dr. Jonathan Pajouh, DPM at NMC Foot & Ankle in Dallas, regularly treats children with heel pain and sports-related foot injuries. He can assess the severity of the condition and recommend a personalized treatment plan.
Who’s Most at Risk?
While Sever’s Disease can affect any child going through a growth spurt, certain factors increase the risk:
1. Active Lifestyle
Children who play high-impact sports like soccer, basketball, gymnastics, track, or football are more likely to develop Sever’s Disease. These activities put repeated stress on the heel and Achilles tendon, which can aggravate the growth plate.
2. Growth Spurts
This condition often appears during peak growth periods. As bones grow faster than muscles and tendons can stretch, the resulting tightness and tension can lead to inflammation at the heel.
3. Improper Footwear
Shoes that don’t provide proper arch support or heel cushioning can make symptoms worse. Kids who wear flat, worn-out sneakers — especially during sports — are more susceptible.
4. Flat Feet or High Arches
Abnormal foot mechanics can put extra strain on the heel. Children with flat feet, high arches, or tight calf muscles may be at higher risk and may need custom support or physical therapy to relieve pressure on the heel.
5. Overtraining
Kids who don't have enough rest days between sports practices or games may be overloading their heels. Without time to recover, small stresses on the growth plate can turn into a more persistent and painful issue.
Signs and Symptoms to Watch For
The most common symptom of Sever’s Disease is heel pain, especially after physical activity.
Here are some typical signs:
-
Pain in one or both heels
-
Limping or walking on tiptoes to avoid pressure
-
Swelling or tenderness at the back of the heel
-
Stiffness in the foot, especially in the morning
-
Discomfort that improves with rest
If your child is experiencing any of these symptoms — especially if they’re involved in sports — it’s worth getting an evaluation to rule out more serious issues. Dr. Pajouh often has same day appointments available for unique situations!
Diagnosis and Treatment Options
If you suspect your child may have Sever’s Disease, it's important to consult a foot and ankle specialist.
Diagnosis is typically based on a physical exam and medical history. In some cases, X-rays may be used to rule out other conditions.
Treatment for Sever’s Disease is usually non-surgical and may include:
-
Rest from high-impact activities
-
Ice therapy to reduce inflammation
-
Stretching exercises for calves and Achilles tendon
-
Supportive shoes or orthotics
-
Temporary use of heel lifts
-
Over-the-counter pain relief (as directed by a physician)
In more severe cases, immobilization with a walking boot may be recommended for a short period.
Preventing Future Flare-Ups
While Sever’s Disease often resolves as the growth plate closes (usually by age 15), there are steps you can take to minimize the risk of recurrence:
-
Encourage regular stretching before and after activity
-
Make sure your child wears supportive shoes, especially during sports
-
Allow adequate rest between games and practices
-
Watch for signs of overtraining or heel discomfort
With proper care and guidance, most children recover fully and can safely return to their favorite activities.
Book a Consultation Today
If your child has persistent heel pain, don’t ignore it. Early evaluation can prevent it from worsening and help your child recover faster. Sever’s Disease is common but treatable—and it doesn’t have to keep your child on the sidelines. Dr. Jonathan Pajouh at NMC Foot & Ankle in Dallas provides expert, compassionate care for kids and teens with heel pain. With personalized, non-invasive treatments like rest, proper footwear, and physical therapy, Dr. Pajouh helps young patients get back to doing what they love—pain-free.