Sever’s Disease

What is it? 

Sever’s disease refers to a condition occurring in pre-adolescents that causes pain, swelling and soreness in the heel bone, also known as the calcaneus. The medical term for Sever’s is calcaneal apophysitis. 

Sever’s causes pain on either side of, and/or on the bottom of the heel. During a certain period of pre-adolescent development, the growing heel bone is vulnerable to overuse when the child is involved in a lot of running and jumping activities. The Achilles tendon places chronic traction on the growing bone, which can lead to inflammation and even irregular calcification in the area.   

Why come to The Children’s Hospital for treatment of this condition?

Children’s has the only sports medicine program in Colorado that is focused solely on caring for young athletes. Our team of sports medicine experts understand the demands that sports programs place on school-aged athletes and the importance of customized, age-appropriate care. Since many young athletes are still growing, they need special kid and teen-specific treatment that takes this into consideration.

Our pediatric specialists are fellowship-trained in sports medicine, giving them the focused expertise that makes The Children's Hospital the best choice for young athletes looking to maximize performance after recovering from a sports injury.

What are the signs and symptoms?   

Young athletes with Sever's complain of pain with activity and tenderness over heel bone. Swelling may appear and the heel can be painful to touch. The pain and swelling often improve with rest.

How do you diagnose it?

The diagnosis of Sever’s disease is based on the classic history, physical examination, and occasionally an x-ray of the heel. The common history is activity-related pain in patients within the age group where the bone is growing rapidly. Examination usually reveals tenderness over the heel bone. 

Radiographs of the heel are sometimes obtained to take a closer look at the growing area of bone, or to investigate for other causes of heel pain.

How do we treat it?

Sever’s disease is treated by focusing on controlling the pain. This condition can be frustrating as the child or adolescent is prone to this pain during the length of the growth spurt (usually around 2 years). Once the child's growth spurt is over, the pain should resolve. 

In the meantime, the child may choose to participate in fewer activities to avoid heel pain. Rest should be encouraged based on the pain, but the child should be allowed to return to activity once the pain is under better control. 

Gel heel cups placed in athletic shoes often provide some relief from the pain. Ice over the painful area after workouts can also be helpful. For severe pain, over the counter medicine may also be considered. Stretching the muscles around the heel, near the Achilles tendon, are protective of the heel and are recommended. 

Who gets it, and can it be prevented?

Sever’s disease only occurs during a certain period of pre-adolescence, when the heel bone is going through a rapid growth spurt. In girls this typically occurs around 8 to 10 years of age, and in boys between ages 10 and 13.

Sever’s disease is more common in active, athletic children. The condition is difficult to prevent completely, but making sure to modify the amount of activity when a child is experiencing pain will help.