Sever’s Disease (Calcaneal Apophysitis)
Summary
Sever’s Disease, also called calcaneal apophysitis, is a common cause of heel pain in growing kids, especially those between the ages of 8 and 14. It usually happens in adolescents who are very active in sports like soccer, basketball, or running. It is more common in boys. Sever’s Disease is not really a “disease,” but an overuse injury that affects the growth plate (apophysis) at the back of the heel bone (called the calcaneus). Growth plates are areas of developing cartilage that are weaker than regular bone. Repetitive running and jumping put stress on the heel’s growth plate, causing pain and inflammation. The condition is named after James Sever, who was the American orthopaedic surgeon who described the condition in 1912.
How Sever’s Disease Is Diagnosed
Doctors usually diagnose Sever’s Disease by talking to the patient about their pain and examining the foot. They will often press on the back of the heel to see if it hurts and check how the patient walks or runs. Most of the time, no special tests are needed because the story and exam are enough. However, if there is concern about other problems, the doctor might order an X-ray to rule out a fracture or other bone issues. X-rays can show if there is swelling or changes around the growth plate, but they are mainly used to make sure it’s not something more serious.
Treatment of Sever’s Disease
Treatment for Sever’s Disease is usually simple and focuses on letting the heel rest and heal. The first step is often resting from high-impact activities that cause pain, like running or jumping. Ice can help reduce swelling, and over-the-counter pain medicines like ibuprofen may also be helpful. Wearing good, supportive shoes or adding a heel cushion insert can take pressure off the heel. Gentle stretching exercises for the calf muscles can also help because tight muscles can pull on the heel. Most kids recover fully with these simple treatments, and the condition usually goes away once the growth plates close after puberty.
Edited by Stephen Pinney MD, April 25th, 2025
