“Mum my heels are sore”
Do you have a child who…
- Is aged between 8-15
- Complains about pain in one, or both, heels
- Has heel pain that gets worse with exercise but better with rest
- Sometimes limps off the sports field, or avoids touching their heel to the ground
…then they may have Sever’s Disease - but not to worry, although this condition can be painful, it is temporary and has no long term side effects.
What is Sever’s Disease?
Sever’s (or calcaneal apophysitis in physio speak) is an overuse condition that affects children, particularly those that are active. It causes pain in the heel, and can affect one, or both sides.
In children who are still growing, the heel is made up of two bones joined by a cartilage plate, called a growth plate. At the edge of these plates, the cartilage is slowly turning into bone. This occurs in almost every bone in the body and is how our bones grow.
Sever’s pain comes from irritation of this growth plate. This occurs due to repetitive contraction of the calf pulling through the heel via the Achilles tendon.
Sever’s often occurs during times where there is an increase in physical activity levels. Common examples are the start of the sports season, the cross country season, or athletics days.
What are the symptoms?
- A Painful heel – one or both
- Swelling at the bottom of the Achilles
- Pain that gets worse with increased activity
- Pain that is relieved by rest
- Children often hobble or limp from the sports field
- In severe cases, children may avoid touching their heel to the ground
What should you do about it?
The first thing is to make sure the diagnosis is correct! Come and see a Motus physiotherapist for an assessment. We will take a thorough history and then complete a physical assessment to make sure that your child’s pain is definitely Sever’s.
Once confirmed, treatment will frequently include:
- Rest! Often a short period of rest is needed to settle down the irritation. This usually means just limiting the amount of physical activity, but in severe cases may mean complete rest.
- Icing: Ice helps to settle down pain, and is especially useful post sport/exercise
- Heel raises: Inserting a small heel raise in your child’s shoes can help to offload the heel
- Calf stretching
- Calf strengthening
- Sometimes, a referral to a podiatrist is recommended.
How long will it last?
As long as there is a growth plate, there can be Sever’s pain, so it is not uncommon to have flare ups of symptoms from time to time. Most of the time, with appropriate treatment, pain is gone within two weeks to two months.
About the author: Ethan is a physiotherapist based out of Motus Lincoln. Ethan is our key contact for the Lincoln University Sports Scholar program.