Sever’s Disease in Children and Teens

What is Sever’s disease?

Sever’s disease is a very common cause of heel pain in kids and teens. It’s most common in kids ages 8–14, especially boys.

What causes Sever’s disease?

Sever’s disease happens when the Achilles tendon pulls on the growth plate in the heel bone. This happens in children who are involved in running and jumping activities, and is facilitated by asymmetric rapid bone growth that outpaces the growth of muscle and tendons. Therefore, kids commonly develop tight calf muscles naturally as a consequence of growth cycles, and when combined with repetitive impact activity, the risk of developing Sever’s disease can increase.

What are the symptoms of Sever’s disease?

Symptoms of Sever’s disease include:

• Pain on the back or bottom of the heel, in one or both feet
• Pain when the sides of the heel are squeezed
• Limping or walking on tiptoes due to heel pain
• Pain that increases during or after running or jumping

How is Sever’s disease treated?

• Rest: Rest will help improve symptoms, especially if your child is doing a lot of running and jumping in their sport. This is particularly true if pain has gotten so severe as to cause limping.
• Stretching: Your child can incorporate one or two calf stretches into their post-workout routine.
• Heel support: Some patients benefit from using silicone heel inserts in their athletic shoes to provide cushioning and decrease discomfort with play.

How can young athletes reduce their risk of developing Sever’s disease?

Because Sever’s disease can be caused by overuse or repetitive movements, it’s best to cross-train in another sport with less running and jumping, such as swimming, biking, or rock climbing. Gradually increasing the number of hours and effort of training sessions can also decrease risk of developing pain and irritation. Young athletes can maximize risk reduction by consistently maintaining flexibility, especially in their calf muscles.