Is your child’s heel pain more than ‘just growing pains’?

If your child has started complaining of heel pain after running, jumping or playing sport, they may be experiencing Sever's disease. Despite its name, Sever's disease isn't actually a disease. It's a common growth-related condition that affects the heel in active children, particularly during periods of rapid growth. The good news is that, with appropriate physical management, most children recover well and can safely return to the activities they enjoy.

Understanding Sever’s Disease

Sever’s disease commonly occurs during growth spurts, when muscles, tendons and bones grow at different rates. As a result, the Achilles tendon pulls on the growth plate at the back f of the heel bone, leading to irritation. In highly active children, repetitive running and jumping can worsen this irritation.

Sever’s disease is most common in active children aged 8-14 years and typically develops after or during periods of exercise.

Is Your Child Experiencing These Symptoms?

Symptoms of Sever’s disease will often come and go, and can affect one or both heels. Common symptoms include:

• Heel pain

• Swelling surrounding the heel bone

• Pain when the heel is squeezed on both sides

• Limping

• Stiffness in feet after a period of rest

Getting the Right Diagnosis

Sever’s disease is not visible on X-rays and therefore requires a clinical assessment. Because heel pain is common in active children, Sever’s disease is sometimes mistaken for an ankle sprain, heel bruise or even a fracture. A clinical assessment can help identify the source of the pain and guide appropriate management.

How can Sever’s Disease be Helped?

Despite the self-resolving nature of Sever’s disease, it’s tempting to either push through the pain or stop activity altogether, however, neither is ideal. Pushing through can prolong the irritation, while complete rest can lead to a loss of strength and conditioning. The better approach is usually to modify activity: easing off the specific movements aggravating the heel while staying active in ways that don’t provoke symptoms.

Physical therapy is an important part of treating Sever’s disease. Targeted calf strengthening and stretching around the ankle and hip can reduce tension through the Achilles tendon and address any contributing biomechanical factors, helping manage pain and support a smoother return to activity once symptoms settle.

6 Tips for Managing Sever’s Disease:

1. Reduce running and jumping activities temporarily - these movements place repetitive load through the heel’s growth plate through the Achilles tendon, so easing off helps reduce irritation while the area settles.

2. Invest in supportive footwear - shoes with good heel cushioning and arch support help absorb impact forces during walking, running and jumping, reducing the direct load transmitted through the heel.

3. Work on stretching calf muscles - tight calf muscles increase tension through the Achilles tendon, which pulls directly on the heel’s growth plate. A simple daily stretch is a standing calf stretch against a wall, held for 20-30 seconds, 2-3 times per side. It should be done gently and without pain.

4. Ice the heel after activity - applying ice to the area can help manage pain and discomfort in the short term. It won’t solve the issue, however it is effective for symptomatic pain relief.

5. Try strapping the heel - a professional can perform taping in a way that supports the arch of the foot and relieves pressure from the growth plate on the heel. This will provide comfort for children who are still involved in regular physical activity, without irritating the area.

6. Return to physical activity and sport at a gradual pace - since Sever’s disease often improves once growth slows, rather than through a single fixed treatment, a structured, gradual increase in training load (rather than an abrupt return) helps reduce the risk of symptoms flaring up again.

Seek clinical assessment as soon as possible. Even though the condition itself can be self-resolving, management is essential to stop pain and prevent future injury.