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Everything You Need to Know About Sever’s Disease and How to Find Relief

Sever’s disease, also called calcaneal apophysitis, is a common cause of heel pain in growing children and adolescents, especially those who are active in sports. It happens when the growth plate in the heel becomes irritated and inflamed. This condition is often seen in children aged 8 to 14 and is most common in athletes involved in activities like running, jumping, or playing soccer and basketball.

Sever’s disease is not actually a “disease” but rather a stress-related injury that occurs when the Achilles tendon pulls on the growth plate at the back of the heel. The condition typically happens during periods of rapid growth when the muscles and tendons are tighter and place extra strain on the bones.

Symptoms of Sever’s Disease

If your child is experiencing Sever’s disease, they may complain of pain in the back of the heel that gets worse with activity. They might also have a noticeable limp after exercising or playing sports. The pain often eases with rest, but it can return when activity levels increase.

Here are some common signs:

Pain in the heel, especially after running or jumping.
Tenderness when pressing on the heel.
Limping after physical activity.
Swelling or discomfort in the heel.
Tightness in the calf muscles.

What Causes Sever’s Disease?

Sever’s disease usually happens during growth spurts. Children’s bones grow quickly during these periods, but the tendons and muscles (like the calf muscles) don’t always keep up with that growth. This leads to tightness in the muscles, which puts extra stress on the heel.

Factors that may increase the risk include:

Gastroc/soleus tightness (tight calf muscles).
Excessive foot pronation (rolling inwards when walking or running).
Overuse or improper footwear.
Running on hard surfaces or increased activity intensity.

Diagnosing Sever’s Disease

Diagnosing Sever’s disease is usually straightforward based on the symptoms and physical examination. Your healthcare provider might perform a “squeeze test,” where they press on both sides of the heel to check for tenderness. Imaging like X-rays is rarely needed but can help rule out other issues like fractures or infections.

How to Treat Sever’s Disease

The good news is that Sever’s disease typically resolves with the right treatment. The main goal is to help your child return to pain-free activities and sports. Here’s how:

Rest and Activity Modification
The first step is to reduce or stop activities that cause pain, especially running or jumping. Low-impact activities like swimming or biking can help your child stay active without putting strain on the heel.
Ice and Anti-Inflammatory Medications
Applying ice to the affected area can help reduce swelling. Over-the-counter pain relievers like acetaminophen or anti-inflammatory medications can also help manage the pain.
Stretching and Strengthening
Stretching the calf muscles (gastroc/soleus) is very important for relieving tightness. Strengthening exercises for the foot and ankle can improve stability and reduce the risk of recurring pain. Myofascial release can also be helpful for relaxing tight muscles.
Proper Footwear and Orthotics
Make sure your child wears shoes that provide good support and cushioning. Orthotics may also be recommended to correct any issues with foot mechanics, like excessive pronation. Adding a half-inch heel lift to the shoes can help reduce the strain on the Achilles tendon.
Kinesiotaping
Kinesiotaping can help support the heel and reduce discomfort during recovery. This therapy is especially useful when your child is returning to light activity.
Activity Modification
In some cases, your child may need to take a break from sports that involve a lot of jumping and running. You can encourage them to cross-train with activities like swimming or cycling, which are gentler on the heel.
Rest and Recovery
In most cases, with proper rest and treatment, the pain should subside within a few weeks. During this time, it’s important to avoid activities that stress the heel and allow the body to heal naturally.

When to Seek Further Treatment

If your child’s pain doesn’t improve with rest and conservative treatments, further interventions may be needed. For instance, a CAM walking boot may be used for a few weeks to protect the heel and promote healing. In rare cases, surgery may be required, but this is typically only after other treatments have failed.

Preventing Sever’s Disease

Once your child has recovered, there are a few things you can do to prevent Sever’s disease from returning:

Encourage your child to keep up with stretching, especially the calf muscles.
Make sure they wear shoes with proper arch support and cushioning.
Gradually increase activity intensity rather than jumping into high-impact sports too quickly.
Avoid prolonged running or jumping sessions on hard surfaces.

Sever’s disease may cause temporary discomfort, but with the right care and rest, most children recover fully and can return to their favorite activities. Remember, this condition is self-limiting, meaning it will resolve as your child’s growth plate matures. By managing the pain, providing proper footwear, and using stretching and strengthening exercises, you can help your child heal and avoid future issues.

If you’re unsure about the next steps or need additional guidance, consulting a referring physician can provide further clarity and help you find the best approach for managing the condition.

If you’re looking for more tips on healthy aging, lifestyle education, and better mobility, check out our recent articles for more helpful information.

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