What Is Sever's Disease?

Sever's disease is a swelling and irritation of the growth plate in the heel. The growth plate is a layer of cartilage near the end of a bone where most of the bone's growth happens. It is weaker and more at risk for injury than the rest of the bone.

Luckily, Sever's disease usually goes away within a few months and doesn't cause lasting problems.

What Are the Signs of Sever's Disease?

Sever's disease usually causes pain or tenderness in one or both heels. It also can lead to:

• swelling and redness in the heel
• stiffness in the feet when first waking up
• limping, or walking on tiptoes
• pain when the heel is squeezed on both sides

Symptoms are usually worse during or after activity and get better with rest.

What Causes Sever's Disease?

Sever's disease happens during the growth spurt of puberty. Your bones, muscles, and tendons grow at different rates then. The muscles and tendons can get tight, pulling on the growth plate in the heel. Activities and sports pull on the tight muscles and tendons, injuring the growth plate. This is what leads the pain of Sever's disease.

Less often, Sever's disease can happen from standing too long, which puts constant pressure on the heel.

Who Gets Sever's Disease?

Sever's disease usually happens in kids who are:

• in their growth spurt (usually 9–14 years old)
• active in sports or activities that involve a lot of running or jumping, especially on hard surfaces (such as basketball, gymnastics, and track)

What Do Doctors Do?

To check for Sever's disease, doctors:

• ask about a kid's physical activities
• do an exam, paying special attention to the heel

A kid with Sever's disease needs to cut down on or stop doing all activities that cause pain. Walking and non-weight bearing exercises (like swimming) are usually OK.

The doctor also might recommend:

• Putting ice or a cold pack on the heel every 1–2 hours, for 15 minutes at a time. (Put a towel over your skin to protect it from the cold.)
• Using heel gel cups or supportive shoe inserts to lower the stress on the heel.
• Wearing shoes that are open in the back so your heel is not irritated.
• Using an elastic wrap or compression stocking to help with pain and swelling.
• Having your parent give you medicine for pain, such as ibuprofen or acetaminophen.
• Trying physical therapy (PT) or a home exercise program from your doctor to help with stretching and strengthening.
• Wearing a walking boot that limits the movement of the ankle/heel.

Sometimes a short leg cast is put on for about a week if:

• Symptoms are severe.
• Symptoms don't go away with a few weeks of rest and treatment.

Can Kids with Sever's Disease Still Do Sports?

Kids can go back to sports when the activity does not cause any pain.

With rest, Sever's disease usually gets better within 2 weeks to 2 months. Most kids can do all of the sports and activities that they did before.

To help prevent Sever's disease from coming:

• Wear shoes and sneakers that fit well and have padded soles.
• Don't wear heavy or high-heeled shoes.
• Stretch before and after activity and sports.
• Put ice on the heel for 15 minutes after activity and sports (with a towel over the skin to protect it from the cold).
• Use special shoe inserts.
• Lose weight (if overweight).

Usually by age 15, the growth plate is finished growing. After that, you won't get Sever's disease again.

Reviewed by: Alvin Wei-i Su, MD
Date Reviewed: 14-01-2019