Heel Pain in Children: Managing Sever’s Disease

Heel Pain in Children: Managing Sever’s Disease

Sever’s disease or calcaneal apophysitis is a very common cause of heel pain in children and adolescent athletes. It is most common between the ages of 8-14 years of age, especially during a period of rapid growth, combined with a high level of sporting activity.

Sever’s disease is more likely in teens who participate in sports that involve running, twisting and jumping, such as basketball, football and gymnastics.

What is Sever’s Disease?

Sever’s disease is thought to occur in children due to the mismatch in growth between the faster growing bones and slower growing muscles.

When the bones lengthen and the muscles don’t, the calf and its tendon (Achilles Tendon) become tight, putting extra-stress on its attachment site on the heel bone (Calcaneus), causing a traction injury.

The traction causes tiny bits of bone to pull away, causing inflammation, which is when the pain usually begins.

Why is it called Sever’s Disease?

It was named after JW Sever who coined the disease in 1912.

What symptoms can children have?

  • Pain at the back or bottom of the heel.
  • Limping.
  • Walking on toes.
  • Pain when contracting the calf  against resistance.
  • Pain when sides of the heels are squeezed together.
  • Tenderness and pain becoming worse during and after exercise.

What are the treatment options?

Sever’s disease often resolves by itself within 12 months or so. However, the heel may remain uncomfortable for around two to three years until the growth spurt finishes.

Treatment options may include:

  • Frequent use of icepacks to reduce the swelling and pain.
  • Sufficient rest to ease the symptoms. Relative rest is essential, only do as much exercise as it will allow without causing pain. Athletes do not have to stop competing, often a modified training regime is sufficient. Persistent painful activities will only worsen symptoms & prolong recovery.
  • Stretching exercises for the calf muscles are often cited as a management strategy, however, they are ill advised as they could exacerbate symptoms.
  • Soft cushioning heel raises placed in the back of your shoes.
  • Correction of any biomechanical issues that have been identified by your physiotherapist, which may cause the condition to become worse.
  • Very rarely, a walking boot may be used if the condition is severe enough or has persisted for an extended period.

Professional help

If the pain in your heel or child’s heel that you are managing yourself has not improved after a few days, it is best to seek advice and consult with one of the physiotherapists at Jubilee Sports Physiotherapy to get an accurate diagnosis.  It is important to ensure that Sever’s disease is the actual diagnosis. Other sources of heel or calf pain require different treatment.

Contact one of our physiotherapists for advice on an appropriate exercise program and suggest the most appropriate treatment plan.

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I came to Jubilee Sports Physio for help on how to exersise and get fit without injuring myself constantly.During my initial consultation Michael said, I was standing wrong, sitting wrong and exersises I did were not suitable for my body.After four sessions, 15 minutes of daily exercises in between and I can go on hikes, lift weights and feel many years younger.I now have the life I want and very grateful to Jubilee Sports Physio, for their professionalism from booking, greeting and being able to do all I want physically.I highly recommend Jubilee Sports
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I would like to express my sincere appreciation for the exceptional care provided by Michael and James for attending to my son, both before and after his shoulder reconstruction. Michael and James' combination of kindness and professionalism played an important role in helping my son navigate through what was his first significant life challenge.They both demonstrated an unwavering commitment to my son's well-being, providing not only expert physiotherapy but also a level of compassionate support that went above and beyond.Thank you Jubilee team for your outstanding commitment to patient care. It's reassuring to know that professionals like Michael and James are dedicated to not just addressing physical challenges but also fostering a supportive and empathetic environment for individuals facing health setbacks. The receptions ladies were kind and helpful too.
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Over a period of 4 years my husband and I have had the expertise and professionalism of Michael Gabriel and staff at Jubilee Sports Physiotherapy Each of our ageing conditions required commitment to exercises to improve. When the conditions were clearly explained we gained confidence and understanding of realistic outcomes. We feel very fortunate for all of our treatments..and highly recommend Michael and staff.
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The whole Jubilee team is fantastic. They are professional, knowledgeable and have always gotten me back playing football as quick as possible!
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The team at Jubilee have been looking after me for over 15 years. Specially Michael with the help of Kieran. They have rehabbed me through 4 major surgeries as well as long standing injuries. It is because of these guys, I am able to still be involved in the game I love, stretching my career out as long as possible. In addition, my whole family is part of the Jubilee family
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I have relied on Michael Gabriel for my physiotherapy needs for a number of years now. His professional work has allowed me to continue to chase the love I have for outdoors recreation.
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I have been attending Jubilee physio, on and off, for many years.In fact three generations of my family are presently receiving treatment there. I have had several of the physiotherapist at Jubilee work on different problems and have found them all to be professional, knowledgeable and very caring in their treatment.
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The the treatment I received for injury was first class. Caring, knowledgeable and highly professional. The electronic home exercising provided to me showed me the required exercises so I was not let to a piece of papers directing me. Loved the app. This physio is the best I have used. Highly recommended.
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