Sever's Condition (Heel Pain)

What is Sever's condition?

Sever's condition — also called calcaneal apophysitis — is a common cause of heel pain in active children, typically between the ages of 8 and 14. It happens at the growth plate at the back of the heel where the Achilles tendon attaches.

During growth spurts, this growth plate is more vulnerable to repeated tugging and impact. Sports involving running and jumping — football, athletics, gymnastics, dance — are common triggers.

Like Osgood-Schlatter at the knee, Sever's is a benign, self-limiting condition that resolves once the growth plate matures. It can be uncomfortable and disruptive for an active child but it's not dangerous.

What does it feel like?

The classic story is heel pain in an active child. Common features include:

• Pain at the back of the heel during or after sport

• Tenderness when pressing on the back of the heel

• Pain on jumping or running, easing with rest

• Limping after particularly active days

• Often affects both heels, though one may be worse

Symptoms tend to fluctuate with activity and growth phases. A bad few weeks during a heavy training period followed by relative settling is a familiar pattern.

How is it diagnosed?

Diagnosis is clinical. The age, activity level, location of pain and pattern of symptoms usually make the picture clear.

Imaging isn't routinely needed. X-rays may occasionally be useful if the picture is atypical or to exclude other causes of heel pain.

The assessment also considers contributing factors — calf and Achilles flexibility, training volume, footwear — because these all influence the right plan.

What are the treatment options?

Sever's is managed without surgery. The aim is to reduce symptoms while letting the natural process complete. Activity modification, stretching of the calves and Achilles, ice after sport, supportive footwear and sometimes heel inserts all play a role.

Most children continue to participate in sport, with a sensible plan that protects them from doing too much. Symptoms typically resolve completely once the growth plate matures. Nev will work through the right plan for your child at your consultation.

When should you get it checked?

Seek a specialist assessment if:

• Your active child has persistent heel pain

• Pain is interfering with sport or activity

• Self-management hasn't produced improvement

• You're worried about whether continued sport is wise

• You want a clear plan to manage symptoms while staying active

Sever's is one of the more recognisable paediatric sports conditions. With the right approach, most children stay active throughout and come out of it without lasting issues.