Calcaneal Apophysitis is also known as Sever’s Disease, even though it is not a true disease. It is a painful inflammation of the heel’s growth plate. It can occur in one or both feet. It is most common in children between the ages of 8 and 14 years old because the heel bone (calcaneus) is not fully developed until at least 14. When there is too much repetitive stress on the growth plate, inflammation can develop.

Heel pain in adults often subsides after walking for a bit. If children have Sever’s Disease, walking will not help the pain. Typically, walking will make the pain worse.


Overuse and stress on the heel bone through participation in sports are a major cause of Sever’s Disease. The heel’s growth plate is sensitive to repeated running and pounding on hard surfaces, resulting in muscle strain and inflamed tissue. Children involved in basketball, track, and soccer are at higher risk for developing Sever’s Disease. Obesity, a tight Achilles tendon, and other problems such as flatfoot or a high-arched foot can also potentially cause Sever’s Disease.

Symptoms- Symptoms may include:

  • Walking on toes
  • Fatigue
  • Pain when the heel sides are squeezed
  • Pain in the back or bottom of the heel
  • Limping
  • Difficulty running, jumping, or participating in sports

Treatment- Treatment may include:

  • Orthotics or Inserts: Temporary inserts or custom orthotic devices to support the heel
  • Limit Activity: Reduce or stop any activities that cause pain
  • Medications: Nonsteroidal anti-inflammatory drugs such as Ibuprofen can help reduce pain and inflammation
  • Support the heel: Temporary shoe inserts or custom orthotic devices may provide support for the heel
  • Immobilization: In severe cases, a cast may be used to promote healing and keep the foot and ankle immobile
  • Physical therapy: Stretching or physical therapy can sometimes be used to promote healing

Prevention- There are some things you can do to try and help prevent heel pain in your children:

  • Maintain a healthy body weight
  • Choose supportive shoes that are activity appropriate
  • Limit or avoid wearing cleats
  • Don’t allow activities beyond your child’s ability

If you or your child is experiencing any pain in the heel, foot, or ankle, please contact Dr. Kylin Kovac at Idaho Foot and Ankle Center!

Content provided by The ACFAS.