Sever's Disease: Heel Pain in Young Athletes

Here's a scene I see regularly in clinic: a child comes back from soccer and walks only on his tiptoes because "the heel hurts too much." You look and there's nothing swollen or red — yet the pain keeps coming back with every practice. This is almost certainly Sever's disease.

Technically, it's a calcaneal apophysitis: inflammation of the heel growth plate where the Achilles tendon inserts. It's the most common cause of heel pain in children aged 8 to 14, especially those in high-impact sports like soccer, track, basketball, and gymnastics. The mechanism is repetitive overload: every jump, sprint, and run transmits force to the heel, which at this age still has an open and vulnerable growth plate.

The reassuring news is that Sever's disease always resolves: when the growth plate permanently closes (between ages 13-15), the pain disappears and doesn't come back. In the meantime, the course is wave-like — there are good weeks and tough weeks, depending on training volume.

Treatment doesn't mean "stop everything": in most cases, reducing the sports load, using silicone heel cushions, regular calf stretching, and applying ice after activity are sufficient. A longer break is only considered if pain is present at rest or causes significant limping.