Sever’s Disease (Calcaneal Apophysitis)

Sever’s disease, medically known as calcaneal apophysitis, is a common cause of heel pain in growing children and adolescents. It occurs when the growth plate at the back of the heel (where the Achilles tendon attaches to the calcaneus) becomes inflamed, usually due to repetitive stress during periods of rapid growth. Sever’s disease typically affects active children engaged in running and jumping sports, often between the ages of 8 and 14. While the term “disease” can sound alarming, it is a temporary, self-limiting condition that resolves when the growth plate closes.

At Elite Physical Medicine, our physiotherapists provide family-friendly, evidence-based care for growing children:

Comprehensive Assessment: We thoroughly assess symptoms, physical activity levels, footwear, and growth history to confirm diagnosis and exclude other causes of heel pain. We can also have one of our Sonographers perform a diagnostic ultrasound scan for a more detailed assessment.

Education & Advice: Clear explanation and reassurance about the self-limiting nature of the condition. Advice is provided on appropriate load management and signs of overuse or aggravation.

Exercise Programme: A personalised programme includes gentle stretching for the calf muscles and Achilles tendon, and strengthening exercises for the foot and lower limb—gradually introduced as pain allows.

Manual Therapy: Gentle massage or soft tissue techniques may be used to ease tightness in the surrounding musculature and enhance comfort.

Pain Management: Advice on using ice packs after activity, appropriate periods of rest, supportive footwear, and over-the-counter pain relief if needed.

Activity Modification: Temporary reduction or modification of high-impact or repetitive sporting activity may be recommended to help relieve symptoms, whilst encouraging continued participation in low-impact activities as tolerated.

Supportive Footwear or Insoles: Recommendations are provided for well-cushioned, supportive shoes and, where appropriate, the short-term use of heel pads or orthotic inserts.

Referral for Further Assessment: Rarely, if pain is severe, persistent, or atypical, further investigation or referral to a specialist may be advised to rule out other causes.

We offer a supportive, educational approach tailored to the needs of children and families, promoting safe activity, comfort, and a positive return to sport. Our physiotherapists are experienced in managing childhood musculoskeletal conditions and will guide you through every stage of recovery.