Heel pain in children and adolescents is often due to Sever's disease, also known as calcaneal apophysitis, an overuse injury in the heel's growth plate where the Achilles tendon attaches to the heel bone. The condition primarily affects children who are active in sports involving frequent running and jumping.
Common signs of Sever's disease in children are:
- pain in the back of the heel
- pain in the evening after sports activities
- limping or prefers to walk on their toes
- less pain in shoes than barefoot
If you want to read more about causes, symptoms, and when to seek care, we recommend our Injury Guide on Sever's Disease.
How is Sever's disease noticed in everyday life?
Many parents discover the problems when their child starts complaining about heel pain after training or a match. The pain can cause the child to limp slightly or avoid putting their heel down properly.
Some children start walking more on their toes to reduce pressure on the heel. Others mostly notice the problems after activity, for example, when they come home from training or school sports.
It is also common for the child to experience less pain when wearing shoes, as the shoes provide some shock absorption. Walking barefoot on hard floors, on the other hand, can make the pain feel more pronounced.
When do the problems usually occur?
Sever's disease typically arises during periods when the load on the heel increases. This can include, for example:
- when training volume suddenly increases
- during tournaments or intensive training periods
- when several activities coincide in the same week
- when training on hard surfaces
Because the growth plate in the heel is still developing during childhood, it is more sensitive to repeated stress than the rest of the foot.
What can help with Sever's disease?
The most important thing is to reduce the load on the heel until the pain starts to subside.
It can often help to:
- reduce or pause activities with a lot of running and jumping
- choose gentler activities such as cycling or swimming
- use heel cups or supportive insoles, such as heel wedges
- choose shoes with a stable heel counter and good shock absorption
Stretching the calf muscles and controlled calf raises can also reduce tension in the Achilles tendon and relieve the heel.
See products that can relieve Sever's disease
Advice for parents
As a parent, you can help your child manage the problems by adjusting the load.
- Help the child listen to the pain – several short sessions are often better than one long one
- Keep track of the total training volume during the week
- Vary between heavier and lighter activity days
- Avoid walking barefoot on hard floors during the symptomatic period
- Inform coaches so the child can participate in alternative activities during training
If you want to understand more about the symptoms, causes, and treatment of Sever's disease, we recommend our Injury Guide on Sever's Disease.
If you instead want help choosing the right support or relief, you can view our Sever's disease supports or contact our physical therapist for personal advice.
