Sever's Disease

Blausen Medical · Wikimedia Commons · CC BY 3.0

Sever's disease (calcaneal apophysitis) is the most common cause of heel pain in children aged 8–15. It is a traction apophysitis — inflammation at the growth plate of the calcaneus where the Achilles tendon inserts — caused by repetitive stress during rapid growth phases when the heel bone is still developing. It is not a true "disease" and resolves entirely with skeletal maturity.

It affects active children, especially those in running and jumping sports. Pain is at the posterior heel, worsening with activity and improving with rest. The squeeze test (medial-lateral calcaneal compression) is positive.

Clinical diagnosis: posterior heel pain in a growing child, positive squeeze test, activity-related pattern. X-rays are usually not required but may show calcaneal apophyseal sclerosis or fragmentation. X-rays are primarily used to exclude other diagnoses (stress fracture, foreign body, infection).

1. NSAIDs / ice

   Acute pain management.

2. Physical therapy

   Once acute pain resolves.

External patient-education references and related OSI pages for additional background:

• Britannica — Ankle (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language