Sever’s disease — heel pain in growing kids.
Heel pain in a 7-12 year old who’s suddenly limping after sport, pinching the back of the heel after football training, or refusing to walk first thing in the morning. Sever’s disease is the paediatric equivalent of plantar fasciitis — common, treatable, and not something to ignore.
What Sever’s disease is.
Sever’s disease (or calcaneal apophysitis) is irritation of the growth plate at the back of the heel bone, where the Achilles tendon attaches. Like Osgood-Schlatter for the knee, it’s an apophysitis — the bone is growing faster than the tendon can keep up with, and the repetitive pull on the growth plate becomes painful.
Most common in 7-12 year olds, particularly during growth spurts and particularly in kids playing impact sports (soccer, AFL, athletics, gymnastics, dance). The pain is typically at the back of the heel, sometimes underneath, often worse first thing in the morning and after sport.
Self-limiting once the growth plate fuses (usually by 14-15 years), but the symptoms can be miserable for the 12-18 months before that. Treatment makes those months considerably more bearable and protects the activity level.
Six elements of Sever’s management.
The combination of these is what shifts most kids out of pain without writing off sport.
Three steps from first visit to outcome.
