If you’re the parent of a tween or teen you know firsthand how quickly children can shoot up during a growth spurt. Although parents are often prepared to discover the milk jug is always empty and all the clothes in their child’s closet no longer fit, many are surprised to hear their child suddenly complaining about painful or tender heels. If your growing child is experiencing heel pain, he/she may have Sever’s disease.
Sever’s disease is swelling of the growth plate at the back of the heel, where the Achilles tendon attaches. When children spurt up, their heel bone sometimes grows more quickly than their Achilles tendon causing the tendon to overstretch. Repeated stress on the overstretched Achilles tendon damages the growth plate over time, causing swelling and pain in the heel.  However, when children stop growing and their growth plate hardens, typically in their mid-teens, Sever’s disease is rarely seen.
Although Sever’s disease is more common in boys it also occurs in girls. It is most frequently seen during growth spurts in children who play a lot of sports that involve pounding and jumping (i.e. soccer, gymnastics, basketball). Growth spurts for boys typically occur between the ages of 10-15 and in girls between ages 8-13. Any child can develop Sever’s disease however, children who have poor biomechanics – feet that roll inwards or outwards when they walk, flat or high arches or leg length discrepancy – are more likely to develop it. Children who wear unsupportive, ill-fitting shoes are also at increased risk.
In addition to heel pain, children who have Sever’s disease may also:

  • Have red or swollen heels
  • Complain of stiff feet when they wake in the morning
  • Walk with a limp or on their toes or find it difficult to walk

If your tween or teen is showing any of these symptoms, book an appointment with a Canadian Certified Pedorthist. The Pedorthist will conduct a full biomechanical assessment of your child’s lower limbs, including assessing how they walk, and then advise you how to ease the pain and prevent it from recurring. Common treatments involve rest, icing, stretching, custom foot orthotics and in some situations heel lifts.
Rest is the primary treatment for Sever’s disease and Pedorthists normally recommend parents reduce all of their children’s activities that put pressure on their heels. Usually the condition disappears within a few weeks and children can then resume their normal activities. However, when the pain is gone, it is important parents take steps to make sure their children’s heels are protected or Sever’s disease will return.
Stable, properly-fitting shoes, that don’t rub or slip at the heels are the best prevention against a recurrence of Sever’s disease. Although tweens and teens often have particular fashion tastes, hold firm when it comes to your children’s footwear or they may find themselves with sore heels that slow the whole family down.
By Paul Mäkinen C. Ped Tech (C), C. Ped (C), Halifax, Nova Scotia