Heel pain in teenagers: Sever’s Disease

Heel Pain in teenagers:

Sever’s Disease

(Calcaneal Apophysitis)


Sever’s disease classically presents as pain at the back of the heel, and occurs predominantly in teenagers, affecting 8-16%1. It is most common after exercise, but can also be noticed during activity, and first thing in the morning1.


Why does it occur?

  • It occurs during adolescence due to growth of the skeletal system, which increases the tension on calf muscles1.
  • These muscles attach into the heel bone (calcaneous) via the Achilles. The increased pull of the muscles on the heel bone causes stress and inflammation, which results in pain.
  • This area is particularly vulnerable as it is the growth plate- the part of the bone from which growth occurs.
  • Increased activity levels, particularly running, put more stress through the area and can aggravate the site2.


How can it be managed?


  • Ice and rest, and non-steroid anti-inflammatories are effective in reducing the initial pain3.
  • Heel inserts will also offload the inflamed area slightly, and are useful in the early stages of the condition3.
  • Depending on the severity of the symptoms, your child may not need time off sport, however if managed incorrectly the recovery time can be significantly lengthened, and pain more severe3.
  • Physiotherapy has been proven to reduce pain and encourage speedier return to depending on the severity of the symptoms1,2,3.
  • Treatment including specific stretches and manual techniques to reduce the stress on the heel bone3.



For more information on Sever’s disease, or any other issues please call Jurassic Physio on 07429831747.



  1. Wiegerinck et al; Incidence of calcaneal apophysitis Eur J Pediatr. 2014 May;173(5):677-9.
  2. Perhamre et al; Sever’s injury: a clinical diagnosis. J Am Podiatr Med Assoc. 2013 Sep-Oct;103(5):361-8.
  3. Elengard et al. Aspects of treatment for posterior heel pain in young athletes. J Sports Med. 2010 6;1:223-32.

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