Heel pain in kids - information on Severs disease by Physiotherapist Malcolm Sanderson

It’s that time of year where kids are getting into their summer sports, athletic camps, and lots of activity!

It is also the time of year where we tend to see an increase in heel related injuries in children and adolescents. In this blog post I wanted to outline a common heel related injury that children can develop during periods of increased activity, bring awareness to it, and offer some guidance on what to do.

Severs, otherwise known as Calcaneal Apophysitis, is one of the most common heel injuries in children. It often affects children between the ages of 8-15 years old, especially when they are going through large growth spurts (Smith & Varacallo, 2024). Severs is most commonly caused by a sudden significant increase in physical activity placed on the heel. Our achilles tendon attaches onto a growth center called an apophysis. As a result of repetitive strain - particularly from running and jumping activities - the achilles tendon pulls on this growth center (Naaktgeboren et al., 2017). This then causes the growth plate on the heel bone to become irritated and painful (See image below).

If your child develops Severs, they may tell you their heel hurts with running and jumping activities but feels better when they are resting. They may also tell you that one heel or both heels are painful. The pain is generally only at the heel and does not travel elsewhere to the lower leg, or foot. Your child may tell you it is tender to touch over their heel. You may also notice your child limping after a bout of activity or sports game due to the pain in the heel.

If your child starts experiencing these symptoms, here are a few strategies you can use with the goal of reducing the irritation in their heel and helping ease their pain (Smith & Varacallo, 2024):

  1. Temporarily reducing the amount of physical activity your child is participating in and instead opting for lowering impact activities such as swimming or cycling.

  2. Icing the heel a few times a day

  3. Using heel inserts/heel pads in their shoes to help provide extra support and cushion to the heel

  4. Ensuring your child stays hydrated, eats a balanced diet, and gets sufficient sleep to help with recovery

It is also important to come in and see a healthcare professional to help accurately diagnose and treat the issue. If you suspect your child has Severs, book an assessment with our skilled physiotherapy team to help diagnose and treat the issue!

References:

Naaktgeboren, K., Dorgo, S., & Boyle, J. (2017). Growth Plate Injuries in Children in Sports: A Review of Sever’s Disease. Strength and Conditioning Journal, 39(2), 59-68. doi: 10.1519/SSC.0000000000000295

Smith, J. M., & Varacallo, M. (2024). Severs Disease (Calcaneal Apophysitis). https://www.ncbi.nlm.nih.gov/books/NBK441928/

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