Hands, Knees and Sever’s Disease: Explaining heel pain in children

Continuing on from February’s newsletter about Osgood-Schlatter’s disease (OSD), we thought we would discuss another activity-based injury commonly seen in children – Sever’s Disease.

What is it?

Sever’s disease describes pain at the back of the heel and typically affects 8-13 year olds.  In adolescents, the heel bone (or calcaneus) is not fully formed until the age of around 12-14 years.  During this time, there is a growth plate at the back of the heel bone, which is separate to the main body of the bone.  When a child is very active or if excessive forces are placed on this area such as those caused by being overweight or having “flat feet”, inflammation occurs at the growth plate.

How do you treat it?

This condition is self-limiting – once the heel bone has fully formed, the pain will dissipate. However, to help with symptoms during the growing period, the following is usually recommended:

• Icing the area

• Stretching of the calf and hamstring muscle groups

• Reducing any aggravating activity

• Wearing adequate footwear with good support and cushioning

• Orthoses if needed

It is best to see a podiatrist as they can advise on correct footwear and help address any biomechanical issues that may be putting excessive strain on the calf and heel such as “flat feet” or excessive pronation/“rolling in” of the feet.  In these cases, orthoses or insoles may be required for additional support.

Of course, Sever’s disease is only one cause of heel pain in children.  

Speak with your podiatrist first to get a correct diagnosis before starting on any of the above recommendations.