Sever’s Disease (Heel Pain in Children) – Bromley Sports Injury Clinic

Key Points

Sever’s Disease (calcaneal apophysitis) is the leading cause of heel pain in children aged 8–14.
It occurs when the growth plate in the heel becomes irritated by repetitive stress, especially in active children during growth spurts.
Symptoms include pain, swelling, and limping after activity.
At Bromley Sports Injury Clinic, we use diagnostic ultrasound to confirm the diagnosis, rule out other causes, and guide treatment.

What is Sever’s Disease?

Sever’s Disease is an overuse injury of the heel growth plate (calcaneal apophysis).

The Achilles tendon pulls repeatedly on the growth plate at the back of the heel.
During growth spurts, bones grow faster than muscles and tendons, increasing tension.
This leads to pain, swelling, and sometimes limping after sport or activity.
Ultrasound helps confirm whether pain is due to growth plate inflammation or other heel conditions.

Symptoms of Sever’s Disease

Heel pain, especially after running or jumping
Swelling and tenderness at the back of the heel
Limping or toe-walking after activity
Stiffness in the morning or after rest
Pain worsens during growth spurts
Often affects both heels, but may be one-sided

Causes & Risk Factors

Children aged 8–14 (growth plate still open)
Sports involving running and jumping (football, gymnastics, athletics, basketball)
Tight calves or Achilles tendon
Rapid growth spurts
Inadequate footwear or poor shock absorption
Training loads that increase too quickly

Why Diagnostic Ultrasound Matters

Heel pain in children is not always Sever’s Disease. Clinical exam can suggest it, but ultrasound provides certainty.

With ultrasound, we can:

Visualise the calcaneal growth plate for inflammation or fragmentation
Assess the Achilles tendon for thickening or irritation
Rule out Achilles tendinopathy, bursitis, or small avulsion fractures
Compare both sides for differences
Track improvement during treatment

👉 This gives parents reassurance and helps avoid unnecessary rest or missed sport.

Diagnosis of Sever’s Disease

At Bromley Sports Injury Clinic, diagnosis includes:

Osteopathic assessment – posture, gait, muscle length, and activity history
Diagnostic ultrasound – to confirm growth plate involvement and exclude other heel causes
Referral – rarely needed, but X-ray may be used if pain is severe or persists

Self-Help for Sever’s Disease

Reduce or modify activity temporarily
Apply ice after sport to reduce irritation
Stretching of calves and Achilles tendon
Supportive shoes or heel cups to absorb shock
Relative rest (not complete rest) — children can usually remain active at a lower load

Treatment Options at Bromley Sports Injury Clinic

✅ Osteopathic care – soft tissue release and joint mobility to reduce tension on the heel
✅ Exercise rehabilitation – stretching and strengthening for calves, Achilles, and foot muscles
✅ Sports massage – to ease calf tightness and Achilles strain
✅ Ultrasound imaging – confirm diagnosis, rule out alternatives, and monitor progress
✅ Training advice – load management, footwear recommendations, safe return-to-sport plans

Prevention

Gradual training progression — avoid sudden spikes in load
Regular stretching of calves and hamstrings during growth
Supportive, cushioned footwear
Cross-training to avoid repetitive impact
Monitor early heel pain and treat before it worsens

FAQs – Sever’s Disease

Q: Is Sever’s Disease permanent?
No. It resolves once growth is complete, but symptoms can last months.

Q: Can my child still play sport?
Often yes, with load modification and stretching. Complete rest is rarely required.

Q: How is Sever’s Disease diagnosed?
Clinical exam and ultrasound together give the clearest picture.

Q: Will it cause long-term damage?
No. Once the growth plate closes, pain usually disappears.

Book Your Appointment

Don’t let heel pain affect your child’s sport or daily activity. Book a Sever’s Disease ultrasound assessment in Bromley today for clear diagnosis, reassurance, and tailored rehab.

📍 Bromley Sports Injury Clinic | Same-week appointments available

Book Your Scan Today