Sever's Disease: What Parents Should Know About Heel Pain in Active Kids

Your child comes home from practice limping, or starts walking on tiptoe after a game. They say the back of their heel hurts. For many active kids, the cause is a common, growth-related condition called Sever's disease. The American College of Foot and Ankle Surgeons calls it "the most common cause of heel pain in children."¹

This guide explains what Sever's disease is, which kids tend to get it, what you can do at home, and the signs that heel pain may be something else that needs a closer look.

What Is Sever's Disease?

Despite the name, Sever's disease is a temporary, growth-related condition.^3,5 Its medical name is calcaneal apophysitis. It is irritation and swelling of the growth plate in the heel bone.^1,4 A growth plate is an area of cartilage where new bone forms, and it is more easily hurt than mature bone.⁴

The Achilles tendon attaches to the back of the heel, near this growth plate. During a growth spurt, bones can grow faster than muscles and tendons stretch.^2,6 A tight Achilles tendon then pulls on the growth plate. Repeated running and jumping add more stress.^2,3

Which Kids Get It?

Sever's disease shows up during the growth years. ACFAS, Cleveland Clinic and Nationwide Children's Hospital put the usual range at ages 8 to 14.^1,2,6 A medical review on NCBI says 8 to 15, and notes that boys are affected two to three times as often as girls.³

It is most linked with sports that involve running and jumping, especially on hard surfaces. Sources name soccer, basketball, track and gymnastics.^1,4 Other things that may raise the risk include:^1,3

• A tight Achilles tendon or limited ankle motion
• Flat feet or high arches
• Being overweight
• Cleated shoes or shoes with poor cushioning
• A big jump in sports activity, or starting a new sport

Less active kids can get it too. OrthoInfo notes it can happen in children who wear flat shoes,⁵ and Cleveland Clinic says ordinary walking can trigger symptoms in some kids.²

What Are the Signs of Sever's Disease?

Common signs include:^1,3,4,6

• Pain in the back or bottom of one or both heels
• Pain that gets worse during or after running and jumping, and eases with rest
• Limping, or walking on the toes to keep weight off the heel
• Pain when the sides of the heel are squeezed
• Mild swelling at the heel

Both heels are often involved. The NCBI review says up to 60% of children have it on both sides.³ Sources differ on mornings. Several list heel stiffness or pain after waking,^2,4,6 while the NCBI review describes pain as usually absent in the morning.³

How Is It Diagnosed?

Sever's disease is mainly diagnosed from your child's history and a physical exam.^3,4 A podiatrist may ask about sports and activities, press on the heel, squeeze its sides, and watch your child walk or run.^3,5 X-rays aren't always needed, but they can help rule out other problems such as a fracture.^3,4

What Can We Do at Home?

Most care for Sever's disease is simple and done at home. Common recommendations include:

• Rest and change activities. Cut back on the running and jumping that cause pain.^3,5 Biking or swimming may be good swaps.⁶
• Ice. Apply ice for 15 to 20 minutes, with a cloth between the ice and the skin.⁶
• Heel cushioning. Gel heel cups or heel pads add shock absorption.^4,5
• Supportive shoes with padded soles that fit well.^4,6
• Calf and Achilles stretches, done regularly and before and after exercise.^5,6
• Over-the-counter pain relievers such as ibuprofen may help.^4,5 Check with your child's doctor or pharmacist about the right dose.

It's worth being honest about the evidence. Studies of Sever's treatments are mostly small. A 2025 review found that conservative treatments "consistently alleviated pain," but described the evidence as "low-certainty" and called for better research.⁸ One study cited in the NCBI review found less pain with all the treatments it compared, with no clear winner among them.³

If pain doesn't ease after several weeks of care, a podiatrist may talk with you about other options. These can include custom orthotics, physical therapy or a short time in a walking boot or cast.^1,3,4 According to the NCBI review, surgery is not used for Sever's disease.³

When Can My Child Go Back to Sports?

KidsHealth says kids can return to sports "when the activity does not cause any pain."⁴ Increase activity gradually and keep up the stretching.⁶ Pain can come back if a child ramps up too fast.⁶

The good news is that Sever's disease doesn't last forever. With rest, it often improves within a few weeks to a couple of months.^2,4 Flare-ups are common when activity increases,³ but OrthoInfo notes it "will not return once a child is fully grown" and the heel growth plate has matured into solid bone.^3,5

Could It Be Something Else?

Not every sore heel in a child is Sever's disease. Doctors also consider conditions such as:^3,8

• A stress fracture or other break in the heel bone
• Achilles tendon problems
• Plantar fasciitis
• Tarsal coalition
• Juvenile idiopathic arthritis
• Bone infection (osteomyelitis), or a bone cyst or tumor

That is why certain signs deserve prompt attention. Nationwide Children's advises calling for severe pain that doesn't improve with rest and pain medicine, severe swelling or redness, a heel injury, or a fever over 101°F.⁶ Seattle Children's adds a child who refuses to use a limb, pain that wakes them from a sound sleep, and pain with a fever.⁷ The NCBI review says imaging such as MRI may be considered when symptoms are unusual, severe or last beyond four to eight weeks.³

You should also get a heel pain evaluation if pain keeps coming back after treatment or doesn't improve when activity is reduced.¹

Can Sever's Disease Be Prevented?

There's no guaranteed way to prevent it, but these steps may lower the strain on a growing heel:^1,4

• Choose well-fitting, supportive shoes with padded soles.
• Limit time in cleats when they aren't needed.
• Stretch the calves before and after activity.
• Keep training at a level that matches your child's ability.
• Support a healthy weight.

The Bottom Line

Heel pain in an active child between about 8 and 14 is often Sever's disease, a growth plate irritation that tends to settle with rest and fades once the heel bone finishes growing. Rest, ice, cushioned shoes and stretching are the usual first steps. Pain after an injury, a child who won't bear weight, night pain, fever, or major swelling or redness are reasons to call promptly.

If your child's heel pain isn't improving, a podiatrist can examine the foot and help sort out what's going on. Request an appointment and our team will follow up within one business day. You can also find your nearest office on our locations page.

This article is for general education and isn't a substitute for medical advice. Talk with a podiatrist or your child's doctor about your child's symptoms.

Sources

1. Calcaneal Apophysitis (Sever's Disease). American College of Foot and Ankle Surgeons (FootHealthFacts.org). www.foothealthfacts.org
2. Sever's Disease (Calcaneal Apophysitis). Cleveland Clinic. my.clevelandclinic.org
3. Smith JM, Varacallo MA. Sever Disease (Calcaneal Apophysitis). StatPearls, NCBI Bookshelf. www.ncbi.nlm.nih.gov
4. Sever Disease (Calcaneal Apophysitis). KidsHealth from Nemours. kidshealth.org
5. Sever's Disease (Heel Pain). OrthoInfo, American Academy of Orthopaedic Surgeons. www.orthoinfo.org
6. Sever's Disease. Nationwide Children's Hospital. www.nationwidechildrens.org
7. Is It Growing Pains or Something More? Seattle Children's. www.seattlechildrens.org
8. Nweke TC. Conservative Management of Sever's Disease (Calcaneal Apophysitis): A Comprehensive Review of Treatment Efficacy. Cureus, 2025. pmc.ncbi.nlm.nih.gov