If your active child is complaining of heel pain, especially during or after sport, there is a good chance it is Sever’s disease. Despite the alarming name, it is not actually a disease, it is a very common and harmless growing-related condition, and it is highly manageable. Most children grow out of it completely.
In this guide for parents we explain what Sever’s disease is, why it happens, how to manage the heel pain, and how physiotherapy can help your child stay active and comfortable.
What Is Sever’s Disease?
Sever’s disease, known medically as calcaneal apophysitis, is irritation of the growth plate at the back of the heel. In growing children, this growth plate is a softer, more vulnerable area than the surrounding bone. When it becomes irritated, usually from a combination of growth and activity, it causes heel pain. It is one of the most common causes of heel pain in active kids, and importantly, it does not cause any lasting harm.
Who Gets Sever’s Disease?
It typically affects active children and teenagers between about 8 and 14, often during a growth spurt. It is especially common in kids who play a lot of running and jumping sports like soccer, netball, basketball, athletics and gymnastics. Boys and girls are both affected. The classic picture is a sporty child who hits a growth spurt and starts limping or complaining of heel pain.
Signs and Symptoms
The main symptom is heel pain, usually at the back or sides of the heel, that is worse during and after activity and eases with rest. You might notice your child limping, walking on their toes, or pulling out of sport. Squeezing the sides of the heel is often tender. The heel pain typically builds with sport rather than coming on from a single injury, which helps tell it apart from an acute problem.
What Causes It?
It comes down to growth plus load. During growth spurts, the bones can grow faster than the muscles and tendons, leaving the calf and Achilles tight and pulling on the heel’s growth plate. Add in the repeated impact of running and jumping, and the growth plate gets irritated. Hard surfaces, poor footwear and a spike in training can all contribute. It is a load-related, temporary problem.
Is Sever’s Disease Serious?
Here is the reassuring part for parents: it is not serious and causes no long-term damage. It is self-limiting, meaning it settles on its own once the growth plate matures, which it always does. It can be painful and frustrating in the meantime, and it can linger or come and go for a while, but it does not cause lasting problems. The goal is simply to manage symptoms and keep your child active and comfortable.
How to Manage Sever’s Disease
Management is all about balancing activity with the growth plate’s tolerance. Helpful steps include reducing or modifying aggravating activity for a time, calf and hamstring stretching, calf strengthening, supportive footwear, and sometimes heel cushions or wedges. Ice after activity can ease symptoms. The aim is not complete rest, but finding a level of activity the heel can handle while you address the tight, weak areas contributing to it.
Does My Child Need to Stop Sport?
Usually not completely. Total rest is rarely necessary or helpful, and most children can keep doing some activity within their comfort. The key is managing the load, reducing it when symptoms flare and building back up as they settle, rather than pushing through significant pain. A physiotherapist can help you find that balance so your child stays involved in the sport they love.
When to See a Physiotherapist
If your child’s heel pain is limiting their activity, not settling, or you simply want a clear plan, a physiotherapist can help. They can confirm it is Sever’s, rule out other causes, and set up a management plan of stretching, strengthening, footwear and load advice. It is also worth getting checked if the pain is severe, present at rest or night, or associated with swelling, as these are less typical.
Common Questions About Sever’s Disease
What is Sever’s disease?
It is irritation of the growth plate at the back of the heel in growing children, causing activity-related heel pain. It is common, harmless and temporary.
How long does it last?
It varies. Symptoms often settle over weeks to months with good management, though it can come and go until the growth plate matures. It always resolves eventually.
Can my child keep playing sport?
Usually yes, with load management. Most children continue some activity within comfort, reducing it during flare-ups. A physiotherapist can help you get the balance right.
Does it cause lasting damage?
No. It does not cause any long-term damage to the heel or growth plate. It is self-limiting and resolves as your child grows.
How can physiotherapy help?
Physiotherapy confirms the diagnosis and provides a plan of stretching, strengthening, footwear and load advice to ease heel pain and keep your child active.
How BeFit Can Help
At BeFit Training Physiotherapy, we help active kids and their families manage Sever’s disease and stay in the game. Our general physiotherapy and sports physiotherapy teams confirm what is going on, ease your child’s heel pain, and build a simple plan of stretching, strengthening and load management, and a running assessment can help for young runners. Initial consultations run for 45 minutes, one-on-one.
Our team at Edgecliff and Coogee would be glad to help. No referral is required, and HICAPS is available on-site for immediate health fund claiming.
Book an appointment at BeFit Training Physiotherapy — no referral needed.
Edgecliff: (02) 9327 7749 | Coogee: (02) 7205 2805 | befittrainingphysio.com/book-now
Related Services at BeFit
Learn more about how our team can help:
General Physiotherapy
Sports Physiotherapy
Running Assessment
Further Reading
Why Young Athletes Get Groin Pain and How to Help
How to Spot and Prevent Injuries in Young Athletes
References
Smith JM, Varacallo M. Sever Disease (Calcaneal Apophysitis). StatPearls. 2023.
Ramponi DR, Baker C. Sever’s Disease (Calcaneal Apophysitis). Advanced Emergency Nursing Journal. 2019.
Australian Physiotherapy Association. Clinical guidelines. physiotherapy.asn.au.
