Growing pains may sound like an old wives’ tale. In the case of Sever’s (or Sever) disease, though, your child’s growth spurt can lead to serious pain. It’s not actually a disease but a heel injury.
What Causes It?
During a growth spurt, your child’s heel bone grows faster than the muscles, tendons, and ligaments in their leg. In fact, the heel is one of your child’s first body parts to reach full adult size. When the muscles and tendons can’t grow fast enough to keep up, they are stretched too tight.
If your child is very active, especially if they play a sport that involves a lot of running and jumping on hard surfaces (such as soccer, basketball, or gymnastics), it can put extra strain on their already overstretched tendons. This leads to swelling and pain at the point where the tendons attach to the growing part of their heel.
How Does It Affect Your Child?
Sever’s disease is more common in boys. They tend to have later growth spurts and typically get the condition between the ages of 10 and 15. In girls, it usually happens between 8 and 13.
Symptoms can include:
- Pain, swelling, or redness in one or both heels
- Tenderness and tightness in the back of the heel that feels worse when the area is squeezed
- Heel pain that gets worse after running or jumping, and feels better after rest. The pain may be especially bad at the beginning of a sports season or when wearing hard, stiff shoes like soccer cleats.
- Trouble walking
- Walking or running with a limp or on tip toes
How Is It Treated?
The good news is that the condition doesn’t cause any long-term foot problems. Symptoms typically go away after a few months.
The best treatment is simply rest. Your child will need to stop or cut down on sports until the pain gets better. When they're well enough to return to their sport, have them build up their playing time gradually.
Your doctor may also recommend:
- Ice packs or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to relieve the pain
- Supportive shoes and inserts that reduce stress on the heel bone. These can help if your child has another foot problem that aggravates Sever’s disease, such as flat feet or high arches.
- Stretching and strengthening exercises, perhaps with the help of a physical therapist
- In severe cases, your child may need a cast so their heel is forced to rest.
Can It Be Prevented?
Once your child’s growth spurt ends, and they've reached full size, their Sever’s disease won’t return. Until then, the condition can happen again if your child stays very active.
Some simple steps can help prevent it. Have your child:
- Wear supportive, shock-absorbing shoes.
- Stretch their calves, heels, and hamstrings.
- Not overdo it. Warn against over-training, and suggest plenty of rest, especially if they begin to feel pain in their heel.
- Try to avoid lots of running and pounding on hard surfaces.
- If they're overweight, help them lose those extra pounds, which can increase pressure on their heels.