Heel Pain in Children (Sever’s Disease)

Written by Michelle Champlin BSc Pod., M.Ch.S., S.R., Ch., (UK)

What is Sever’s Disease?
Sever’s Disease, (otherwise known as ‘calcaneal apophysitis’) is an inflammation of the growth plate in the heel of growing children, most often seen in young adolescents, usually aged between 9 to 16 years old. It is usually seen in very active, sporty children and occurs more frequently in boys than girls and at times of growth spurts. It is named after Dr James Sever, an American Orthopaedic Surgeon, who described it in 1912.
Sever’s Disease is similar to Osgood-Schlatter’s Disease which is a similar issue affecting the knee. With OSD, an increase in sports and physical activity and excessive pronation can cause the patella tendon excessively pull on the tibial tuberosity which then becomes aggravated, inflamed and painful.
What are the signs / symptoms?
Children will complain of pain to one or both heels, which feels better after taking a break from sports for a few days. It is worsened by weight bearing sports or activities such as running, walking and jumping. To the eye, the heels will not look unusual – there is no swelling or redness, with pain to the heel the only symptom. This can also be tested by squeezing the medial-lateral aspect of the heel. Foot x-rays will typically look normal.
How can a Podiatrist help?
Sever’s Disease is commonly seen with overuse of the bones and tendons in the heel. It is commonly associated in children with excessive over-pronation of the sub-talar joints. Therefore, a very helpful course of action is to address the underlying biomechanical anomaly – the over-pronation. The Podiatrists at Dubai Podiatry Centre are biomechanical experts and renowned Chief Podiatrist Michelle Champlin is a PodoPaediatric specialist.
Mrs Champlin advises commencing custom orthotic therapy under the supervision of a qualified and experienced PodoPaediatric podiatrist, who will carefully examine and assess your child and take a mould / cast of your child’s foot in order to hand make their custom prescription orthotics. These should be corrective and made by the Podiatrist, in order to actually address and correct the mal-alignment. It is important that the Podiatrist sees your child back at regular intervals to change the prescription and monitor progress until end of treatment.
Your Podiatrist may also advise a conservative treatment plan of RICE – Rest Ice Compression Elevation, muscle strengthening and stretching exercises for the calf muscles and hamstrings as well as custom prescription orthotics to correct the gait (walking / running pattern).
It may also be advised to take a short break from sports for a couple of weeks to give the heels time to heal – pun intended.
What can happen if it goes untreated? 
Sever’s Disease will eventually go away if left untreated. However, we advise treating to enable the child to continue sports and be active. Generally, very active sporty children are affected so to have the child be told to avoid sports until recovered can be impact on their happiness. Also, the Sever’s Disease can be a signifier to the over-pronation, which will not self-correct and is best corrected before adulthood to avoid developing hip, ankle and knee problems in adulthood.
What Should I Do if I think My Child Has Sever’s Disease?
If your child reports any form of heel, foot, ankle or leg pain early intervention is key. Foot, leg and ankle pain in children should always be thoroughly investigated. If your child is reporting symptoms, similar to those described above, contact Dubai Podiatry Centre on 04 3435390 for an appointment with the UAE’s only PodoPaediatric specialist – Michelle Champlin.