Sever's Disease in Children
A Complete Guide for Parents
Sever’s disease, also referred to as calcaneal apophysitis, is a common cause of heel pain in children between the ages of 6 and 16. This frequent pediatric foot condition affects the growth plate in the heel bone leading to pain and swelling.
What is Sever’s Disease?
Sever’s disease is caused by inflammation of the growth plate in the heel bone during rapid growth spurts. The Achilles tendon and calf muscles tighten as the heel bone grows faster, putting strain on the growth plate.
This irritation of the growth plate in the heel results in swelling, tenderness, and heel pain in one or both feet. Sever’s disease often occurs in active children participating in sports involving running and jumping.
Sever’s Disease Facts
- Affects growing children between ages 6 and 16
- Causes heel pain worsened by activity
- Occurs during growth spurts as muscles and tendons tighten
- More common in boys than girls
- Running and jumping sports increase risk
- Resolves once heel bone reaches maturity
Causes and Risk Factors for Sever’s Disease
The main cause of Sever’s disease is repeated stress to the growth plate in the heel during rapid growth phases. Certain factors put children at increased risk
Growth Spurts
- Growth spurts during puberty cause heel growth plates to be vulnerable.
- Boys tend to get Sever’s disease at age 10-16 during growth spurts.
- Girls tend to be affected earlier between age 6-12 years old during growth phases.
Sports Participation
- Running and jumping sports like soccer, basketball, gymnastics, and track have higher risk.
- Constant pounding on hard surfaces can increase strain on heel growth plates.
Help your kid get off the sideline and back in the game.
Signs and Symptoms of Sever’s Disease
The most common symptom is heel pain affecting one or both feet. Other possible Sever’s disease symptoms include
Heel Pain
- Starts gradually and worsens with physical activity
- Usually occurs at the back of the heel where Achilles tendon attaches
- Often described as aching, stabbing, or throbbing pain
- Can get worse over the course of a day as inflammation increases
Swelling, Limping, Stiffness
- Swelling, redness, and warmth around the affected heel due to irritation
- Limping or altered gait from trying to avoid putting pressure on the heel
- Heel stiffness and restricted range of motion, especially after rest
- Pain and discomfort when the sides of the heel are squeezed (positive squeeze test)
Identifying Sever's Disease
How to Check for Sever's
In this video Dr. Jarman demonstrates how he performs a check for Sever’s in office. While this demonstration can help in identifying Sever’s, there may be situations where an X-ray at the office is required to rule out any other possible conditions.
It’s important to note that this demonstration is not a substitute for an official diagnosis.
For an official diagnosis it is always advised to seek guidance from a licensed pediatric podiatrist.
Mikkel C. Jarman, DPM, FACFAS
"As a Pediatric Podiatrist, I diagnose and manage a wide range of pediatric foot conditions, encompassing various types of heel pain. Among these, particularly in young athletes, Sever's Disease is overwhelmingly prevalent, accounting for over 85% of such cases."
Sever's Disease Treatment
The Only Sever's Disease At-Home Treatment
Long Term Outlook for Sever’s Disease
With appropriate treatment and management, Sever’s disease does not cause any long term issues or complications. The symptoms fully resolve once the child’s heel bone finishes growing and the growth plates close.
Getting prompt treatment for Sever’s disease ensures the best outcome for your child. Please reach out with any additional questions!