Heel pain is a common complaint among children and adolescents who are involved in competitive athletics. Calcaneal apophysitis, also known as Sever’s disease, is the leading cause of heel pain in this age group. Calcaneal apophysitis has historically been most common in boys 10-12 who are involved in sports. However, with the rise in sports participation among girls it is becoming more common particularly in the 8-11 year old age group. In children and adolescents the bones of the lower leg grow faster than the muscles and tendons can keep up with placing increased tension on the growth plate of the heel. This coupled with repetitive micro-trauma and overuse from sports participation results in pain and tenderness to the posterior heel. Sports that are commonly associated with this condition include soccer, gymnastics, football, baseball, hockey, tennis, skating, ballet, and various running sports.

Signs & Symptoms:

  • Pain in one or both heels when running or walking
  • Child/adolescent may compensate by walking on toes
  • Pain with compression of posterior heel and/or Achilles tendon
  • Usually not accompanied by trauma/injury


  • Treatment is focused on reducing pain as the condition will usually resolve on its own
  • Activity modification
  • Icing before and activity
  • Stretching of the calf muscles
  • Heel lifts
  • Short-term immobilization in short leg cast or a below the knee boot is occasionally required
  • Orthotics/Inserts in patients with biomechanical irregularities
  • Physical Therapy 


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