Sever’s Disease (Growing Pains, Kids Heel Pain)

What is Sever’s Disease?

First and foremost, despite its name Sever’s is not a disease. It’s a painful condition that will resolve in weeks, months or even years. Clinically referred to as Calcaneal Apophysitis, Sever’s is usually coined growing pains, though this does not describe how and why the pain occurs. 

What causes Sever’s?

Sever’s is the abnormal tension (pull) on the heel bone, which irritates the nearby growth plate that is present in children’s bones. Growth plates are located on the ends of growing bones and will eventually turn into solid bone when we reach full maturity. As we grow, our bones, muscles and tissues all grow and lengthen too. In Sever’s, the Achilles tendon (which connects to the calf muscles and into the back of the heel) hasn’t developed and stretched at the same rate that the heel bone has been growing, the resulting tension and pull on the back of the heel which becomes very painful.

Anything that increases the strain on the achilles/calves/heels can exacerbate this pain, including:

• Running sports
• Increased physical activity
• Soccer boots and low-heeled shoes
• Tight calf muscles
• Hard surfaces

What does it feel like?

Symptoms often occur between 8-14 years of age, as for most kids this is where they will experience periods of rapid growth. They may feel:

• Pain (sharp or an ache) at the back of the heel
• Pain that occurs during (or after) sports or physical activity, particularly when running
• Abnormal tightness through the back of the legs down to the heel
• Swelling at the back of the heel
• Pain that is reduced with rest and ice, but comes back with activity

How do you treat Sever’s?

They key is not only to settle the symptoms but treat the cause, so that it doesn’t keep coming back for months or years. This means working on the tight musculature to restore normal function. After using rest and ice to reduce the pain if it arises, treatment to eliminate Sever’s pain long-term may include the combination of:

• Orthotics - to keep the foot in its optimal position so that it minimises the tension placed on the achilles where it connects to the heel
• Stretching and strengthening - this will lengthen tight muscles so they can function normally with the other bones, joints and tissues. This also reduces the risk of further injury down the track
• Footwear check - this ensures that footwear isn’t worsening the foot pain. Even good, supportive shoes may have a low set heel which will place more tension on the achilles/heel
• Activity modification - we will work with you to modify regular activities to reduce the tension and pain on your heel

While Sever’s is a frustrating, painful and upsetting condition, you don’t need to put up with it or wait months hoping that it will resolve. We will work to get your little one back on the field and doing the things they love as quickly as possible.