Sever’s Disease (Calcaneal Apophysitis): Treatment, Symptoms and Causes Sydney

Sever’s Disease, now known as calcaneal apophysitis, is a condition that affects children and adolescents. It involves irritation around the growth plate at the back of the heel bone, where the Achilles tendon attaches.

Sever’s Disease can be challenging for active children, particularly those involved in regular sport. Parents, coaches and guardians should be aware of children limping or reporting heel pain or discomfort, especially during or after physical activity.

Sever’s Disease (Calcaneal Apophysitis): Treatment, Symptoms and Causes Sydney

Symptoms

Symptoms of Sever’s Disease can include:

Heel pain during or after physical activity
Discomfort at the back of the heel
Limping
Complaints of heel soreness following sports such as soccer, basketball, gymnastics or running
Pain that increases with repetitive running or jumping activities

Causes

Sever’s disease most commonly occurs in active children and adolescents.

Several factors may contribute to the development of Sever’s disease, including:

Growth spurts: Rapid growth during adolescence can outpace musculoskeletal development, increasing tension through the heel.

High-impact activities: Sports that involve frequent running and jumping, such as soccer, basketball, and gymnastics, can aggravate the condition because of repetitive stress on the heel.

Footwear with a low heel-to-toe drop: Shoes with a low pitch height, such as soccer boots with a 0 mm drop, may increase strain on the heel. By comparison, the average shoe pitch is usually around 5–10 mm.

Diagnosis

Diagnosis of Sever’s Disease is based on reported symptoms and clinical assessment by a podiatrist.

Assessment may include:

Palpation (touching) of the painful area
Evaluation of joint mobility
Observation of walking or running patterns

At Sports Podiatry Manly, we utilise a pressure plate treadmill system (Zebris) to analyse plantar pressures through the feet during movement. This assists in understanding loading patterns that may be contributing to the condition.

Treatment

Management of Sever’s Disease in Sydney focuses on addressing the child’s symptoms and monitoring progress over time. Treatment plans are adjusted based on how the child responds.

In the early stages, incorporating heel raises into the child’s shoes may help reduce load on the affected heel. This should be accompanied by educating the child and parents about appropriate footwear and implementing a tailored load management and strengthening program.

In some cases, orthotics may be recommended for a short period to assist in redistributing loading patterns under the foot. It is important to discuss a gradual exit plan from orthotics as the child continues to grow and develop.

Where pain is more significant, a temporary period of rest may be required. This may involve reducing or pausing high impact activities such as running, soccer, gymnastics or basketball. Recovery time can vary and should be managed on a case-by-case basis.

Sever’s Disease is a common cause of heel pain in growing children, particularly those involved in sport. Early assessment and appropriate management can assist in addressing symptoms and guiding safe return to activity.

At Sports Podiatry Manly in Sydney, our podiatrists provide thorough assessment and tailored management plans for children experiencing heel pain related to Sever’s Disease. If your child is reporting ongoing heel discomfort or limping, booking an assessment may help determine the most appropriate next steps.

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please get in touch with our professional team.

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