Massage therapy · Kitchener–WaterlooSever's Disease

The heel bone is known as the calcaneus. In children, there is a growth area (growth plate) at the back of the heel bone, known as the calcaneal apophysis. The heel bone is not usually fully developed until about the age of 14, at which point the pain often stops (Kent Community Health NHS Foundation Trust, 2024). Until then, repeated stress through the back of the heel can irritate and inflame the apophysis, which is where the name calcaneal apophysitis comes from. A tight Achilles tendon pulling on the heel bone, and having flat or high-arched feet, can also make Sever's disease more likely (Kent Community Health NHS Foundation Trust, 2024).

1. Stretch the calf muscles (Achilles tendon) daily. A podiatrist can show you how, or I can show you and your child. The Kent Community Health NHS Foundation Trust (2024) leaflet suggests a wall calf stretch held for 30 seconds and repeated three times, at least three times a day. Make sure that the stretching exercises do not cause any pain and if they do then stop doing them.
2. Rest from any activities that cause or worsen the pain. Your child can carry on with sport, but if the pain continues it is best to reduce the amount of activity (Kent Community Health NHS Foundation Trust, 2024). If running causes pain then try to avoid running. Substitute another activity for the running… like swimming.
3. Apply ice to the heel for about five minutes during the day to help reduce inflammation. Place a towel between the ice and the heel, and do not apply ice directly to the skin (Kent Community Health NHS Foundation Trust, 2024).
4. Footwear: shoes with soft material at the back, or open-backed shoes, are best, and flat shoes should be avoided (Kent Community Health NHS Foundation Trust, 2024).
5. Heel pads and orthotics: a heel raise or heel pad may give some relief, although the evidence is limited (James, Williams and Haines, 2013). Shoe inserts called orthoses may be prescribed if there is an underlying foot problem such as flat feet (Kent Community Health NHS Foundation Trust, 2024). I can help you work out whether your child needs a heel pad or insert and how to get one, and point you to a chiropodist or podiatrist if they need custom orthoses.
6. Medication: the Kent Community Health NHS Foundation Trust (2024) leaflet says a non-steroidal anti-inflammatory medicine, such as ibuprofen, may help, and that your pharmacist or doctor can recommend the right one. (This medicine information comes from Kent Community Health NHS Foundation Trust, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)
7. Reduce sport until symptoms improve.

There is not really anything that can prevent this condition as it is mostly caused by growing. However, it is something that will be outgrown. There are no long-term effects from having Sever's disease, and it will not affect bone growth. During active growth the pain can come back, particularly if the Achilles tendon tightens again, but once the bone has stopped growing you cannot get it again (Kent Community Health NHS Foundation Trust, 2024).

I can also help you work out whether a heel pad or insert might help and how to get one, and point you to a chiropodist or podiatrist if your child needs custom orthoses.

If your child's heel is swollen or red, the pain is there even at rest, or they can't put weight on the foot, see your family doctor or nurse practitioner.