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HealthInfo Waitaha Canterbury

Sever's disease

Mate whakawaikura rekereke

Sever's disease is the most common cause of heel pain in tamariki (children) between 8 and 14 years old. It's also called calcaneal apophysitis (cal-ca-nee-al ap-o-fy-sigh-tis). It's more common in tamariki who are very active and who play sports that involve a lot running and jumping.

The pain usually improves within weeks with the simple measures described below and is gone within two to three months. It doesn't cause long term problems.

Causes of Sever's disease

Image showing Severs disease, an inflamed growth plate in the heel bone, or calcaneus. The Achilles tendon attaches to the heel bone at the back of the footGrowth plates are areas of growing tissue near the ends of children's bones where they make new bone tissue. Repeated stress on the heel from running and jumping can irritate the growth plate in a child's heel.

Other possible causes of Sever's disease include:

Symptoms of Sever's disease

Tamariki with Sever's disease feel pain at the back of their heel. It usually starts and builds up gradually, and often the tamaiti (child) will limp and feel pain during or after activity. Their heel may also be painful first thing in the morning and get better as they move around.

Sever's disease can affect one or both feet. The affected heel is usually tender and squeezing the heel on both sides will cause pain. Sometimes the affected heel is swollen.

Diagnosing Sever's disease

Your child's GP, physiotherapist or podiatrist will diagnose Sever's disease by examining their heel. They probably will not need any special tests or X-rays.

Helping my child with Sever's disease

Teenager doing up laces on sports shoes, which are best if they have Sever's diseaseYour tamaiti should wear shoes rather than going barefoot, as shoes absorb shock and reduce the impact on their heel. But it's important to choose and wear the right shoes. Shoes should:

When tamariki follow this advice, Sever's disease usually goes away and doesn't need any further treatment.

Getting help for Sever's disease

If the pain isn't getting better after doing the steps above, have your tamaiti child checked by a GP in case there is another cause.

A podiatrist can check your child's feet, legs and the way they walk. They will also let you know which stretches, exercises and footwear will help. They may also give your tamaiti heel raisers, shoe inserts or orthotics, depending on how bad your child's pain is, their age and their foot shape.

A physiotherapist can help by telling you what stretches will help.

Often your podiatrist, physiotherapist and GP will work together to get the best result.

Written by HealthInfo clinical advisers. Last reviewed May 2022.


See also:

Heel & foot pain

Page reference: 368551

Review key: HICLF-132158