Sever’s disease (heel pain in children)

Does your child ever experience pain in their lower legs or heels? For example, after playing sport, but sometimes even whilst resting? People often assume this is growing pains. That may well be the case. Sever’s disease (also known as morbus Sever) is a form of growing pains that is common in children aged between 7 and 12.

There is a growth plate at the back of the heel (the calcaneus). This growth plate does not fully close until around the age of twelve.

During growth, the heel bone is still fragile. The heel bone has to grow in different directions. This means the growth plate can become overloaded more quickly. This can cause pain in the heel.

There are various causes that may contribute to Sever’s disease:

• Plenty of play, exercise and sport. The condition is common in sports such as football, hockey, tennis and basketball;
• Calf muscles that are short or highly developed. As a result, the calf muscles pull extra hard on the heel bone via the Achilles tendon;
• Excess weight. The heel bone is not yet strong enough to support the body’s weight properly;

Sever’s disease can cause pain in one or both heels. A child often notices:

• Prolonged, sharp or stabbing pain at the back of the heel;
• Pain during and after exercising, running, jumping or striking the foot;
• The pain often subsides with rest;
• Sometimes there is slight swelling at the point where the Achilles tendon attaches to the heel bone;
• Some children walk on their toes to take the weight off their heels and reduce pain.

A healthy lifestyle has a positive impact on the body’s resilience. Sufficient exercise, a balance between physical activity and rest, and a healthy body weight can help to distribute the pressure on the heels as evenly as possible during growth.

It can be difficult for children to temporarily cut back on sport or take a rest when necessary. It can also be frustrating if pain prevents them from always taking part in sport or play.

Our lifestyle coaches en occupational therapists can provide support if pain affects movement, work or daily activities.

There is a lot you can do yourself to put less strain on the heel and alleviate your child’s symptoms.

• Make sure you wear shoes with sufficient cushioning and support;
• Alternate sport and exercise with sufficient rest;
• Make sure your child does not carry on suffering in pain for too long;
• Let your child gradually increase their activity level as the symptoms subside;
• Make sure your child wears well-fitting shoes when playing sport;
• Please contact a podiatrist if your symptoms persist or get worse.

Our podiatrists will work with you and your child to assess the symptoms and identify what is causing the heel to become overloaded. During the examination, we will assess whether Sever’s disease is present. If necessary, further podiatric investigations can be carried out.

Treatment may consist of:

• advice on making temporary adjustments to sport and exercise;
• advice on shoes with sufficient cushioning and support;
• podiatry insoles to reduce pressure on the heel;
• exercises to reduce the strain on the heel;
• advice on gradually building up activities.

Sever’s disease is a growth-related condition. Once the growth plate has fully matured, the symptoms usually disappear of their own accord. Until then, we will help your child to continue moving as comfortably as possible and to keep playing sport wherever possible.