Sever’s disease (calcaneal apophysitis) is the most common cause of heel pain in children, particularly between the ages of 8 and 14. Despite its name, Sever’s disease is not an actual disease, but rather an overuse injury affecting the growth plate in the heel. It commonly occurs in children who are active in running and jumping sports.

At Northwest Extremity Specialists, our Portland-area podiatrists provide comprehensive care for pediatric foot conditions, ensuring effective treatment and a quick return to activity.

What Are the Symptoms of Sever’s Disease?

Sever’s disease typically presents as pain and tenderness in the back of the heel. Key symptoms include:

• Heel pain that worsens with activity (running, jumping, or sports)
• Increased pain when the heel is squeezed from both sides
• Limping or walking on toes to avoid heel pain
• Swelling and redness in the heel area
• Sudden disinterest in sports or physical activities

For more information on pediatric heel pain, visit the American Academy of Pediatrics.

What Causes Sever’s Disease?

During childhood, bones are still growing, and the heel bone contains a soft cartilage growth plate. Until around age 14, this area remains vulnerable to overuse injuries, especially in active children.

Risk Factors for Sever’s Disease:

• High-impact sports such as soccer, basketball, and gymnastics
• Growth spurts that cause tight Achilles tendons
• Biomechanical issues like flat feet or high arches
• Running on hard surfaces that increase heel stress
• Poorly fitting or worn-out shoes

For more details on growth plate injuries in children, visit the Cleveland Clinic.

Diagnosing Sever’s Disease

Our pediatric foot specialists at Northwest Extremity Specialists conduct a comprehensive evaluation to confirm Sever’s disease and rule out more serious conditions like bone cysts or ligament injuries. Diagnosis typically involves:

• Medical history review to assess activity levels and symptoms
• Physical examination including the heel squeeze test
• Imaging tests (X-rays) to rule out fractures or structural abnormalities

Treatment Options for Sever’s Disease

Sever’s disease typically resolves over time with conservative treatment. Early intervention helps prevent chronic pain and complications.

1. Rest and Ice Therapy

• Reduce high-impact activities (running, jumping) until pain subsides.
• Apply ice packs for 10–15 minutes several times a day to reduce swelling.

2. Supportive Footwear & Orthotics

• Ensure your child wears well-fitting, cushioned shoes with good arch support.
• Custom orthotics or heel cups may reduce pressure on the heel and improve foot alignment.

3. Stretching and Physical Therapy

• Achilles tendon and calf muscle stretches help relieve tightness and strain.
• Strengthening exercises improve overall foot stability and prevent recurrence.

For recommended stretching exercises, visit the American Orthopaedic Foot & Ankle Society (AOFAS).

4. Pain Management

• Over-the-counter anti-inflammatories (e.g., ibuprofen) may be recommended for temporary pain relief.
• Massage and foam rolling can ease muscle tightness.

5. Immobilization (Severe Cases)

• If pain persists or worsens, a walking boot or short cast may be used to immobilize the heel for faster healing.

For a complete guide on pediatric sports injuries, visit the National Library of Medicine.

When to See a Pediatric Foot Specialist

You should seek medical attention if your child:

• Has persistent heel pain that limits daily activities
• Experiences pain in both feet simultaneously
• Loses interest in sports or physical activity due to discomfort
• Shows signs of swelling, redness, or difficulty walking

Contact a Pediatric Foot Specialist in Portland Today

At Northwest Extremity Specialists, our pediatric podiatrists specialize in diagnosing and treating Sever’s disease to ensure fast relief and safe return to sports.

Schedule an appointment with Northwest Extremity Specialists to discuss effective heel pain treatments for your child.