SoccerSever's Disease (Calcaneal Apophysitis) is the most common cause of heel pain in children, especially active children.  Rarely if ever will a child have the other causes of heel pain including plantar fasciitis.  Sever's Disease is an inflammation of the growth plate (physis) at the back of the foot where the Achilles tendon attaches. 

Signs and Symptoms

  • Pain to the heel or even the ankle
  • Difficulty walking or running
  • Discomfort when heel is squeezed on both sides
  • An unusual walk, such as walking with a limp or on tiptoes to avoid putting pressure on the heel
  • Possible swelling and redness in heel


Although the name might sound pretty frightening, Sever's disease is really a common heel injury that occurs in kids. It can be painful, but is only temporary and has no long-term effects.  Symptoms will ultimately resolve when the heel stops growing and the growth plate fuses.


  • Heel Cups - Although other treatments are available, this is the most effective treatment to reduce the pull of the Achilles tendon and reposition the fat of the foot under the heel.
  • Heel Lifts - Sometimes a heel lift will reduce the stretch of the Achilles enough to alleviate the pain.
  • Custom Orthotics - By modifying the function of the foot and positioning the heel in the ideal position, the pain is improved.
  • Other - Heel pads and elastic stockings may reduce the pain, but are often ineffective.

Common Causes:

  • Sports - Due to the high level of activity associated with sports now, everything from soccer to gymnastics, dance to football can cause the stress to the growth plate of the heel and lead to symptoms.
  • Pronated Foot (a foot that rolls in toward the arch when walking or running) which causes tightness and twisting of the Achilles tendon, thus increasing its pull on the heel's growth plate
  • Flat or High Arch, which changes the angle of the heel and can further stress the Achilles tendon
  • Short Leg Syndrome (one leg shorter than the other) can produce stress from the Achilles tendon causing the foot of the short leg to bend downward to reach the ground and/or the long leg trying to shorten further stressing the Achilles tendon in both cases
  • Overweight or Obesity
Brandt R Gibson, DPM
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Podiatrist, Neuropathy Doctor, Father of 11 and Founder of Mountain West Foot & Ankle Institute