Does your child suffer from heel pain?

Calcaneal apophysitis or Sever’s Disease as it is better known, is regularly seen amongst active adolescents experiencing growth advancements between the ages of eight and fourteen. severs
The young athlete, particularly those who are experiencing both physical and physiological changes in the lead up to maturity can be at increased risk of sports related injury. The main causes of this form of heel pain is:

  • Physical activity – any form of exercise that is weight bearing through the legs or stresses the soft tissue can exacerbate the pain of the disease. Particularly running, basketball and football.
  • External factors – for example, running on hard surfaces or wearing inappropriate shoes during sport.
  • Overuse injury – very active children may repeatedly but subtly injure the bones, muscles and tendons of their feet and ankles.
Signs and Symptoms

Pain felt at the insertion of the achilles tendon will usually increase with activity. Additionally, there may be restricted range of motion at the ankle and trigger points or tightness within the calves as muscle growth is thought to lag behind that of bone growth resulting in significant imbalance.

A child wearing poor footwear which does not accommodate their structural needs, over-trains or trains in a way which detrimental to health is at increased risk of developing severs.
Parents of young athletes will commonly comment on a child’s gait including a limp during sport or training and complaints of pain while barefoot.


Patient load management is most important to be effective in reducing pain at the heel. In the early stages or reactive stages of Sever’s pain general first aid practices should be completed including; rest, localized icing/cold therapy, compression and elevation. If this fails to resolve the problem then it is important to seek an allied health professional such as podiatrist for further treatment.


It is known that injury is a major barrier to sport participation, it is estimated that up to 50% of adolescent sport related injury is preventable. Balanced training has been seen to reduce lower limb injuries as well as multiple intervention approaches with warm up, muscle stretching and cool down.

If you or your child suffers from this complaint it is best to see a qualified sports podiatrist first before returning to sport to determine the extent of the injury and treat any other factors that may be involved.

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