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  • Nicola
  • by admin
  • August 5, 2019
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Heel pain in Children

This is something that we, as paediatric physiotherapists, come across very often with our patients.  It is one of the common conditions of the growing, (and normally sporty) child and can sometimes be dismissed by parents.

“Heel pain” in children is often diagnosed as “Sever’s disease”.  Do not worry, it is not a true disease and cannot be caught!

Sever’s disease” is Calcaneal apophysitis.  This means that there is inflammation/injury where the large tendon of the calf muscles (the Achilles tendon) attach to the heel bone. Where the tendon attaches to the heel bone is where growth occurs, termed the “growth plate”.

What causes it?

During a growth spurt, the bones, muscles, and tendons grow at different rates. The muscles and tendons can become tight, pulling on the growth plate in the heel. Activities and sports pull on the tight muscles and tendons, causing repetitive stress to the heel. This injury leads to the pain of Sever’s disease.


  • Most commonly occurs in sporty children
  • Girls: 8-10 years old
  • Boys: 10-12 years old

Risk factors

  • Active growing children
  • Rapid growth
  • Young athletes who push through activity related pain
  • Poor flexibility in leg muscles and weakness
  • Poor footwear
  • Vitamin D deficiency

What are the signs to look for in your child?

  • Complaints of foot/heel pain (most commonly in the morning and during/after walking/running and jumping/sports)
  • Walking/running on toes to avoid heel contact or limping
  • ‘Stiffness’ of the affected foot on waking up
  • Poor flexibility
  • Tenderness on the heel/around the back of the foot or on the Achilles tendon itself
  • Pain that settles with rest
  • Swelling/redness on the heel


What can you do?

  • Advise your child to take some rest from the aggravating activity
  • Apply an ice pack to the heel/painful area
  • Come and see one of our doctors for an assessment
  • Start physiotherapy sessions with one of our team!

Some children end up having to stop the sport that they love because it gets too painful, and they don’t seek the help that they need.  There are some really simple physiotherapy treatments to carry out for this condition which can make a big difference to your child’s life!  Our physiotherapy team can help manage the condition so that your child can participate in their chosen sport.  Treatment may include stretches, strengthening, and taping.  Advice on footwear and orthotics will also be given.

With proper management and depending on severity, Sever’s disease usually goes away within a few weeks to months and doesn’t cause lasting problems.

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