What is Sever's disease?

Sever's disease is a common cause of heel pain in children. The pain can come and go for months, or a few years. But it doesn't usually lead to any long-term problems.

Sever's disease is also known as 'calcaneal apophysitis'.

Who gets Sever's disease?

Sever's disease often first appears in children when they are aged between 8 and 12 years. This is when they are growing rapidly and their bones are still maturing. Highly active children are most at risk.

What are the symptoms of Sever's disease?

Sever's disease may affect one or both feet.

Symptoms can include:

• pain or tenderness in the heel, especially during or after exercise
• mild swelling around the heel bone
• limping

Symptoms tend to be worse during or after exercise or physical activity. The symptoms usually get better with rest.

What causes Sever's disease?

When your child has a growth spurt, the bones, muscles and tendons (which attach muscles to bones) grow and change rapidly. The area of growth in bones (called the growth plate) is weaker than normal bone and is more likely to be injured.

When the bones in the lower leg (the tibia and fibula) grow quickly, the Achilles tendon (the large tendon that attaches the calf muscles to your heel bone) becomes tighter. This can add stress to the growth plate of the heel bone, causing it to become swollen and painful.

Exercise, such as running and jumping puts extra pressure on the heel over the growth plate. Wearing sports shoes that have studs on the soles can also increase your child’s risk of Sever's disease.

You can reassure your child that the pain will disappear when their heel bones stop growing.

When should I see my doctor?

Take your child to see your doctor or a physiotherapist if they are complaining of pain in the heel or are limping.

How is Sever's disease diagnosed?

Diagnosing the cause of heel pain can sometimes be a challenge.

Your health professional will usually start by asking some questions about where exactly the pain is and when it first appeared. They will also examine your child's feet.

Tests such as x-rays or blood tests are not normally needed to diagnose Sever's disease.

In some cases, your doctor may refer your child to a specialist.

How is Sever's disease treated?

Your doctor or physiotherapist may recommend that your child does the following:

• Temporarily stops doing activities that cause the heel pain.
• Uses ice packs to reduce the pain or swelling.
• Does calf stretches daily. Your physiotherapist can show you how to do these.
• Wears gel heel pads or cushions in their shoes.
• Wears comfortable shoes with good heel lift or arch support.

To ease the pain, children may need to cut down on sports that involve lots of jumping and running. These include:

• basketball
• netball
• gymnastics
• Australian rules football
• athletics

They can usually continue with low-impact activities like swimming and cycling.

Your child can get back to their normal activities after the pain eases.

Sever's disease can take between a few months and a few years to go away. Often it comes and goes, but there shouldn't be any lasting problems.

Sever’s disease is uncommon after the age of 15 years, when the heel bones have finished growing.

Resources and support

Arthritis Australia has further information about Sever’s disease.

You can also call the healthdirect helpline on 1800 022 222. A registered nurse is available 24 hours a day, 7 days a week.