Severs disease or calcaneal apophysitis is a common problem of the heel in growing children. At the back of the heel bone is a growth plate which most of the growth of the heel bone takes place at and this condition is an overuse injury of that growing area. It is more common in kids that are active, are overweight and are taller. The classic symptoms of Severs disease is pain at the back and sides of the heel bone, especially after sport. Severs disease is considered to be a self limiting condition, in that the child will always eventually grow out of it once growth of the heel pain stops and the growing area of cartilage within the bone merges with the rest of the heel bone. That does not mean it should not be treated and can not be helped before that growth stops.
The best approach to manage this condition is managing the child’s and parent’s expectations and lifestyle to keep the symptoms under controls. The loads need to be managed via modifying and restricting activity levels. This can be difficult and may need some negotiation with the child. If the pain is severe after sport, then ice can be used to help relieve that. Often a cushioned heel insert can help protect the area. Long term the prognosis is good as they will grow out of this by the mid-teenage years.