Understanding Calcaneal Apophysitis (Sever’s Disease): A Common Cause of Heel Pain in Kids

If your child or teen is suddenly complaining of heel pain, especially during or after sports, there’s a good chance it’s not just growing pains—it might be calcaneal apophysitis, more commonly known as Sever’s disease. Despite the alarming name, Sever’s disease isn’t a disease at all—it’s a common and temporary condition that affects growing children, especially those who are active.

Let’s break down what Sever’s disease is, what causes it, how to recognize it, and how it’s treated. We’ll also explain how it can be confused with plantar fasciitis—and how to tell the difference.

What Is Calcaneal Apophysitis (Sever’s Disease)?

Sever’s disease is an inflammation of the growth plate in the heel (the calcaneus). In kids, the heel bone is not fully developed until the early to mid-teen years. Until then, it has a soft growth plate that can become irritated when stressed repeatedly—especially from activities like running, jumping, and playing sports.

This condition typically affects children between ages 8 and 14, with a peak during growth spurts when bones grow faster than muscles and tendons can keep up.

Causes of Sever’s Disease

The main cause is repetitive stress on the heel during physical activity. Common contributing factors include:

Growth spurts, where tight muscles (especially the Achilles tendon) pull on the heel

High-impact sports like soccer, basketball, track, and gymnastics

Poor footwear that doesn’t provide enough support or cushioning

Flat feet or high arches, which can alter biomechanics and increase heel strain

Obesity, which puts additional pressure on the feet

Common Symptoms

Heel pain, especially at the back or bottom of the heel

Pain that worsens with activity (running, jumping) and improves with rest

Limping or walking on tiptoes to avoid putting pressure on the heel

Tenderness when the sides of the heel are squeezed

No visible swelling or bruising

It often affects one heel, but it can also occur in both feet at the same time.

Sever’s Disease vs. Plantar Fasciitis: What’s the Difference?

Because both conditions cause heel pain, Sever’s disease is sometimes mistaken for plantar fasciitis, which is more common in adults. Here's how to tell them apart:

Sever’s Disease                                                                                      Plantar Fasciitis

Affects children (typically ages 8–14)                              Affects adults (usually 40+)

Pain in the back or bottom of the heel                           Pain in the arch or bottom of the heel

Pain worsens with activity, improves with rest            Pain is worst in the morning or after sitting

Tender when squeezing sides of the heel                      Tenderness at the bottom front of the heel

No swelling or arch collapse                                               May have arch tension or tight calves

If your child is active and in the right age range, Sever’s disease is more likely than plantar fasciitis.

Treatment: Rest, Support, and Patience

The good news? Sever’s disease is temporary and doesn’t cause long-term damage. Most kids recover with simple, non-invasive treatments:

Rest and reduce activity: Temporarily stop or limit sports to allow healing

Ice: Apply ice packs to the heel for 15–20 minutes after activity

Stretching exercises: Focus on the calves and Achilles tendon

Heel cushions or orthotics: These provide extra shock absorption and reduce stress

Proper footwear: Supportive, cushioned shoes are essential—avoid flat or worn-out shoes

Pain relief: Over-the-counter anti-inflammatories like ibuprofen can reduce discomfort

Most cases resolve within a few weeks to a few months, depending on activity level and adherence to rest and treatment. In rare or severe cases, physical therapy or a short period in a walking boot may be recommended.

Final Thoughts

Heel pain in kids shouldn’t be ignored. While Sever’s disease may sound serious, it’s a normal part of growing up for many young athletes—and with proper care, they’ll be back on the field or court in no time.

If you’re ever unsure whether your child’s heel pain is Sever’s disease, plantar fasciitis, or something else, a visit to a podiatrist or orthopedic specialist can provide peace of mind and a treatment plan. Catching it early helps prevent further irritation and keeps your child moving comfortably.