Sever's disease factsheet
Introduction
Sever's disease is a common cause of heel pain in children aged 9 to 13. It happens when the growth plate in the heel becomes irritated as your child grows.
Growth plates are soft areas of cartilage at the ends of bones that help them grow. In Sever's disease, tight muscles and tendons pull on the heel’s growth plate, causing swelling and pain.
This condition is more common during growth spurts and in children who play sports or do activities that involve:
- back and forth movements in the heel
- running
- jumping
- standing.
Common sports that can trigger sever's disease include:
- soccer
- rugby (league, AFL, and union)
- hockey
- basketball
- netball
- tennis
- ballet.
Sever’s disease goes away once the growth plate finishes growing.
Signs and symptoms
Symptoms usually affect one or both heels and include:
- pain that worsens over time
- pain when pressure is put on the heel
- swelling, redness or stiffness
- limping or changes in how your child walks.
See your local doctor or physiotherapist if your child develops any of these symptoms during activity, even if mild.
Diagnosis
A doctor or physiotherapist will check your child’s heel and ask about their activities. They may gently move the foot to see where it hurts.
X-rays or scans are not usually needed unless there could be another cause for the pain.
Treatment
Treatment depends on how severe the pain is. Your child’s doctor may recommend:
- taking a break from activities that involve running and jumping until the pain gets better
- applying ice to the heel for 20 minutes after a painful activity
- using gel heel inserts or raises to reduce strain
- physiotherapy to stretch and strengthen the leg muscles
- checking your child’s movement during growth spurts
Pain relief medication may also help. With rest and care, symptoms usually improve over time.
Management
Returning to sports and activity
Your child can slowly return to activity when symptoms improve.
If pain is severe, they may need to take a break from sport for 1–2 seasons.
Talk to the doctor or physiotherapist about changes to activities and movement to avoid pain.
Speak to your child's school, coaches, or other activity coordinators to make sure there is a plan in place to help your child have a safe and pain-free return to their activities.
Sever's disease and other conditions
Other issues can be confused with Sever’s disease or increase the chance of getting it.
These include:
- flat feet – where the bones and tissue in the arch of the foot touch the ground
- stress fractures – when a small crack or break happens in the bone after repeated stress or strain
- achilles tendonitis – when there is pain and swelling in the thick tendon at the back of the ankle caused by tears or breaks
- juvenile rheumatoid arthritis – a condition where the immune system attacks healthy tissue in the body, causing swelling and stiffness in the joints
- bursitis – swelling or inflammation of small, fluid-filled sacs that help reduce friction in body parts that move, like the joints.
Your doctor or physiotherapist will rule out these conditions before confirming the diagnosis.
See your local doctor if the pain doesn’t improve with treatment.
Preventing Sever's disease
Sever’s disease starts slowly, so building good habits early helps to prevent it.
Good habits for sports and activities include:
- taking regular breaks during activity
- stopping exercise if pain starts
- stretching often
- warming up before and cooling down after activity
- wearing well-fitting, supportive shoes
- using kneepads during sport
- learning and using safe movement techniques for jumping and running.
