Understanding Sever’s Disease: Exploring Symptoms, Causes and Treatment


Achilles Tendonitis graphic

Sever’s Disease

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You’ve probably heard of Sever’s Disease, but do you really understand what it is?

It’s a common cause of heel pain in active children, typically rearing its head during those pesky growth spurts. Imagine the discomfort of running, jumping, and even walking with this condition. Yet, it’s not all doom and gloom. There are ways to manage and even prevent its impact. Interested in finding out more? Stay tuned for an in-depth exploration of this often misunderstood children and adolescents condition.

What is Sever’s Disease

Often, physically active kids between the ages of 8-14 experience heel pain, a common symptom of Sever’s disease, especially during growth spurts. This ailment, also known as calcaneal apophysitis, typically strikes when your child’s heel bone, or growth plate, is still developing.

Symptoms often flare during activities that involve running or jumping and tend to worsen after exercise. You might notice your child limping or walking on their toes to avoid putting pressure on their heel. Don’t dismiss this as a typical sports injury; it could be a sign of Sever’s disease.

Sever’s disease often correlates with changes in height, weight, and physical activity levels, making it prevalent among sporty children. Don’t let the term ‘disease’ scare you, though. It’s not a chronic or life-threatening condition, but rather a temporary inflammation of the growth plate in the heel.

Diagnosing Sever’s disease usually involves a physical exam and observation of symptoms. Your child’s podiatrist may assess their pain level, check for tenderness in the heel, and examine the flexibility of the calf muscle. Treatment generally involves rest, heel support, calf muscle stretches, and measures to control and manage the pain.

Causes and Risk Factors

When your child hits their growth spurt, they’re more likely to develop Sever’s disease, especially if they’re actively engaged in high-impact sports. This condition can cause significant heel pain, mainly due to the stress on the growth plate at the back of the heel.

The rapid growth of bones in your child’s feet during their growth spurt can outpace the muscles, leading to a tight Achilles tendon. This tightness, coupled with high-impact activities like running or jumping, obesity, or biomechanical issues such as flat feet can increase irritation in this area, putting additional stress on the heel’s growth plate, causing Sever’s disease.

Here’s a simple breakdown:

Risk Factor


Rapid Growth

Bones grow faster than muscles, leading to tightness

High-Impact Sports

Adds additional stress on the growth plate

Tight Achilles tendon

Contributes to the development of Sever’s disease


Most common in children aged 8-14 during growth spurts

Common Symptoms of Sever’s Disease

In children suffering from Sever’s disease, you’ll frequently notice heel pain that intensifies during running and jumping activities. This heel pain is a result of inflammation in the growth plates found at the back of their heels. The growth plates are still developing in children, which makes them more susceptible to irritation and swelling.

Apart from heel pain, other common symptoms of Sever’s disease include limping or walking on toes to avoid putting pressure on the heel. You might also observe that these children have difficulty participating in sports or physically demanding activities, due to discomfort. If you were to press on the back of their heel, they’d likely experience pain, signaling a possible case of Sever’s disease.

Morning discomfort, particularly following sports activities, is another symptom to watch out for. This pain often comes and goes depending on the child’s activity level. It’s important to understand that these symptoms aren’t permanent. As the growth plates harden and mature, the symptoms of Sever’s disease will gradually disappear. However, it’s essential to manage the symptoms effectively to guarantee your child’s comfort and well-being.

Diagnostic Procedures

To diagnose Sever’s disease, your child’s doctor or podiatrist will typically conduct a thorough physical examination and assess the symptoms present. This is a critical step in the diagnostic procedures for Sever’s disease, as it helps to confirm the presence of calcaneal apophysitis and rule out other potential causes of heel pain.

The healthcare provider may palpate (press & examine) your child’s heel, looking for areas of tenderness or swelling. This can often provide a clear indication of Sever’s disease. However, in some cases, additional diagnostic procedures such as X-rays might be required to exclude other conditions.

Sever's Disease Diagnostic

As part of the diagnostic procedures, let’s consider the following table to understand the process better:

Steps in DiagnosisPurposeDiagnostic Tool
Physical ExaminationTo assess the presence of Sever’s diseasePalpation, Observation
Symptom AssessmentTo understand the severity of the conditionPatient’s Feedback
X-raysTo rule out other potential causes of heel painMedical Imaging

Treatment Options

Dealing with Sever’s disease, you’ve got several treatment options on the table, ranging from regulating activity to pain-based interventions. Your podiatrist will often suggest a variety of strategies to help you manage your childs pain and combat the progression of the disease.

  1. Activity modification: You’ll need to cut back on activities that cause pain in their heel or calf muscle. This doesn’t mean they need to stop being physically active, but you might’ve to adjust their routine.
  2. Orthotic devices: Using an orthotic can provide relief by redistributing pressure away from the heel. This can alleviate discomfort and promote healing.
  3. Therapeutic exercises: There are exercises aimed at stretching and strengthening the calf muscle, which can help take some pressure off the growth plate in the heel.
  4. Medication: If pain persists, over-the-counter anti-inflammatory medications may be recommended.

Remember that Sever’s disease generally resolves on its own over time. So, while these treatments can help manage symptoms, patience is key as the growth plate heals. Always consult your doctor or podiatrist before starting any new treatment strategy.

Managing Pain at Home

Sever's Disease Rest and Relaxation

When it comes to managing Sever’s disease at home, rest and activity modification are your first lines of defense against pain. This condition is largely due to bone growth outpacing that of the surrounding tissues, leading to inflammation and discomfort in your child’s heel. It’s important to limit high-impact activities that exacerbate the pain.

Next, consider stretching the calf muscles. Gentle exercises can help alleviate the pressure on the growth plate in the heel, easing the pain. Your podiatrist or possibly a referred physiotherapist can assist with appropriate stretches that won’t further injure the area.

Applying ice or cold packs to the affected area can help reduce inflammation and numb the pain. It’s a simple and effective method you can easily do at home.

Furthermore, it’s beneficial to ensure your child has good support in their footwear. Proper shoes can provide the needed cushioning and support, reducing the strain on their heel. Avoid letting them walk barefoot, particularly on hard surfaces.

Lastly, over-the-counter pain medications, like ibuprofen, can be used to manage the discomfort. Always follow the package instructions and consult your healthcare professional if the pain persists.

Sever’s Disease Long-Term Effects

While managing the immediate discomfort is important, you may also be wondering about the potential long-term effects of Sever’s disease. It’s natural to feel a bit anxious, but you’ll be relieved to know that long-term complications are rare. Most children outgrow the condition with the maturity of the growth plate.

  1. Growth Plate Maturity: Sever’s disease typically resolves itself once the growth plate matures. This natural process means that as your child grows, the chances of the disease recurring diminish.
  2. Recurrence Prevention: Good sports shoes support is key in preventing a recurrence. Ensuring your child wears well-fitted and supportive footwear, especially during physical activities, can make a significant difference.
  3. Podiatric Consultation: A podiatrist can provide specific advice on long-term management of Sever’s disease. This expert input can be invaluable for monitoring the condition and managing any potential recurrence.
  4. Long-term Management: With the right approach and advice, long-term management of Sever’s disease is straightforward and manageable. It’s mainly about monitoring your child’s activity level and ensuring they wear supportive footwear.

Prevention Strategies

To effectively prevent Sever’s disease, it’s crucial that you adopt specific strategies aimed at reducing stress on your child’s heel and maintaining their overall physical health. Encouraging proper warm-up and cool-down routines before and after physical activities can greatly lessen the impact on the heel’s growth plate. This routine helps prepare and relax the calf muscles, reducing the risk of strain during intensive activities.

Moreover, the footwear your child uses can make a notable difference. It’s vital to make sure they wear supportive, well-fitted shoes with ample cushioning. This helps to distribute pressure evenly across the foot, minimizing stress on the heel. Step Ahead Podiatry can help suggest footwear at your appointment.

Limiting high-impact activities, particularly during growth spurts, can also prevent overloading the growth plate. Instead, gradually increase the intensity of physical activities, adjusting it based on your child’s age and physical development.

Lastly, incorporate regular stretching exercises targeting the calf muscles into your child’s routine. These exercises improve flexibility and contribute to a balanced muscle structure. By reducing the strain on the heel growth plate, these preventative measures can significantly decrease the likelihood of your child developing Sever’s disease.

When should I see a Podiatrist?

Often, seeking professional help from podiatrists can greatly improve your child’s condition if they’re suffering from Sever’s disease. As professionals, we are equipped with the knowledge and skills to diagnose and manage this condition effectively.

Sever’s Disease may be an unwelcome hitch in your child’s active lifestyle, but remember, it’s not a permanent setback. With proper care, pain management, and monitoring, it won’t be long until they’re back in the game.

Keep an eye out for symptoms, get help if needed, and always encourage safe play. Your understanding and support will make a big difference as your child navigates this temporary challenge.

Remember, Sever’s Disease is treatable and preventable.

Step Ahead Podiatry Clinic

If you think that you may have this condition (or another) and want some friendly expert advice and treatment, please feel free to contact us a Step Ahead Podiatry.

Step Ahead Podiatry is located in Mount Eliza, along the Mornington Peninsula of Victoria. 

We are ready to take your enquiries for a consultation on 03 9708 8626 or you can find our contact form on our Contact Us page if you prefer written communication.

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