Understanding Sever’s Disease: A Parent's Guide

Q: What causes Sever’s disease?

Children’s bones grow from areas called growth plates. The growth plate at the back of the heel is where the Achilles tendon attaches. During periods of rapid growth, the bones can grow faster than the muscles and tendons can adapt. This can create increased tension through the Achilles tendon and the heel's growth plate. When this is combined with regular running, jumping and sporting activity, the growth plate can become irritated and painful. Sever’s disease is particularly common between approximately 8 and 15 years of age, although the exact age varies depending on the child's growth and development.

Q: What does Sever’s disease feel like?

The most common symptom is pain at the back or underneath the heel. Your child may experience: - Heel pain during or after sport - Pain that increases with running or jumping - Tenderness when the heel is squeezed from the sides - Stiffness or discomfort after periods of activity - Limping or avoiding activities because of pain - Pain that improves with rest but returns when sporting activity increases Some children will have pain in one heel, while others may experience symptoms in both feet.

Q: Is Sever’s disease serious?

The good news is that Sever’s disease is generally a temporary condition and does not cause permanent damage to the foot. However, continuing to push through significant heel pain can make symptoms persist for longer and may prevent your child from participating comfortably in sport. The goal of treatment is therefore to reduce irritation and manage the load being placed through the heel while your child continues to grow.

The Foot Clinic Group

Sep 14

3 min read

Updated: Oct 13

What Causes Sever’s Disease?

Children’s bones grow from areas called growth plates. The growth plate at the back of the heel is where the Achilles tendon attaches. During periods of rapid growth, the bones can grow faster than the muscles and tendons can adapt. This can create increased tension through the Achilles tendon and the heel's growth plate. When this is combined with regular running, jumping, and sporting activity, the growth plate can become irritated and painful.

Sever’s disease is particularly common between approximately 8 and 15 years of age, although the exact age varies depending on the child's growth and development.

What Does Sever’s Disease Feel Like?

The most common symptom is pain at the back or underneath the heel. Your child may experience:

Heel pain during or after sport
Pain that increases with running or jumping
Tenderness when the heel is squeezed from the sides
Stiffness or discomfort after periods of activity
Limping or avoiding activities because of pain
Pain that improves with rest but returns when sporting activity increases

Some children will have pain in one heel, while others may experience symptoms in both feet.

Is Sever’s Disease Serious?

The good news is that Sever’s disease is generally a temporary condition and does not cause permanent damage to the foot. However, continuing to push through significant heel pain can make symptoms persist longer and may prevent your child from participating comfortably in sport. The goal of treatment is therefore to reduce irritation and manage the load being placed through the heel while your child continues to grow.

How Is Sever’s Disease Treated?

Treatment depends on the severity of your child's symptoms and their sporting demands. At The Foot Clinic Group, we look at the whole picture — including your child's foot function, footwear, activity levels, muscle flexibility, and sporting requirements.

1. Managing Activity

Your child may not need to stop all sport. Instead, we often look at reducing or modifying activities that aggravate the heel, while maintaining activities that are comfortable. For example, temporarily reducing high-impact running and jumping may allow symptoms to settle while your child remains active in other ways.

2. Calf and Achilles Flexibility

Tight calf muscles can increase the load through the Achilles tendon and heel. A tailored stretching program may be recommended to improve flexibility and reduce stress on the heel.

3. Supportive Footwear

Appropriate footwear can make a significant difference. A well-fitting shoe with adequate cushioning and support can help reduce the impact placed on the heel during sport and everyday activities.

4. Heel Lifts or Orthoses

Some children benefit from a temporary heel raise or orthotic device. These can help reduce tension through the Achilles tendon and alter the load passing through the heel while symptoms settle. Whether these are appropriate depends on your child's individual foot mechanics and symptoms.

5. Gradual Return to Sport

Once pain has settled, returning to sport should be gradual rather than going straight back to full training. Increasing training volume too quickly can cause symptoms to return. A podiatrist or other healthcare professional can help develop a return-to-sport plan that suits your child's sport and level of activity.

Should My Child Play Through the Pain?

A little discomfort does not necessarily mean your child needs to stop all activity, but significant or increasing pain shouldn't be ignored. A useful approach is to monitor symptoms during and after activity. If pain is progressively increasing, causing a limp, or remaining elevated after exercise, the activity load may need to be reduced.

When Should My Child See a Podiatrist?

If your child's heel pain is persistent, affecting their ability to walk or play sport, or repeatedly returning after activity, it is worth having it assessed. Heel pain in children can have several causes, so an appropriate assessment is important before assuming it is Sever’s disease. At The Foot Clinic Group, we can assess your child's feet, lower-limb mechanics, footwear, and activity levels to determine what may be contributing to their symptoms and develop an appropriate management plan.

The Good News

Sever’s disease is common, manageable, and usually resolves as the heel growth plate matures. The key is finding the right balance between allowing your child to remain active and giving the irritated heel enough time to recover. If your child is experiencing ongoing heel pain, don't let them simply "push through it". Early assessment and appropriate load management can help them get back to the activities they enjoy.

Conclusion: Taking the Next Steps

Is your child experiencing heel pain? Book an assessment with The Foot Clinic Group to have their symptoms and foot function assessed and to develop an individualised treatment plan.

Book an appointment here

This article is intended for general information only and is not a substitute for an individual medical or podiatry assessment. Persistent or severe pain should be assessed by an appropriately qualified healthcare professional.