Severs Disease


Sever’s disease (also known as calcaneal apophysitis) is inflammation of the heel bone growth plate, caused by excessive forces during early adolescence. It is common in physically active growing children between the age of 7 and 14 years.

Pain is often felt in the back of one or both heels and increases upon rising on tiptoes and during high impact sports that involve running/jumping. Sever’s is something that children grow out of, however pain and discomfort can be reduced so the child is more comfortable during this phase.




Sever’s disease is caused by a mismatch in the growth of the calf bones relative to the calf muscles.

During a growth spurt, the heel bone grows faster than the muscles, tendons and ligaments in the leg. When the bones grow faster than the muscles, the Achilles tendon that attaches the calf muscles to the heel gets tight. It then pulls on to a weak spot on the heel (growth plate). The growth plate of the heel is cartilage that has not yet ossified (turned into bone) and thus is prone to injuries.

The pull of the tight calf muscles and the Achilles tendon to this weak spot causes a traction injury, resulting in inflammation, swelling and pain experienced in the heel.


  • Deep ache at the back of the heel bone (which increases with activity)
  • Swelling and redness at back of the heel
  • Difficulty walking (i.e. limping)
  • Change in walking pattern, (i.e. walking on tip toes to protect the heel)
  • Calf muscle stiffness first thing in the mornings


  • Tight calf muscles
  • High levels of sport participation (Involving ballistic movements e.g. Jumping, sprinting etc.).
  • Inappropriate footwear
  • Incorrect foot biomechanics (e.g. Excessive pronation)
  • Over weight


A thorough physical examination is conducted to rule out other causes of heel pain, such as Plantar Fasciitis and Achilles Tendinitis. The range of movement in the ankle is also assessed to examine calf muscle tightness. Leg length discrepancy is also examined, as a longer leg compensates for the difference in length by taking more load during walking and running, thus placing more pressure on the foot.

This is followed by a gait analysis to examine foot function while the child is walking, and in some instances running.

A footwear assessment is also conducted to ensure shoes are appropriate and have adequate shock absorption in the heel.

In some instances, a referral for an X-ray is made.

Consult now for an extremely reliable Sever’s disease treatment at Sydney Heel Pain Clinic.