Sever's Disease in Children
Symptoms, Causes and Treatment of Sever's Disease and Related Heel Pain
Sever’s disease, also known as calcaneal apophysitis, is a painful inflammation in the heel that results from a dramatic growth spurt. The inflammation comes about due to an abrupt growth when the heel bone grows at a faster rate than surrounding muscles and tendons which become overstretched and tight.
Girls may see their spurts between 6 – 13 years old while boys will experience them around 10 – 16 years of age (depending on individual children’s development rates).
For more detailed advice on how to identify and treat Sever’s disease at home, read Dr. Jarman’s At-Home Guide. »
How to Identify Sever's Disease
The Squeeze Test
This diagnosis of Sever’s is identified easily at the office by simply grasping your child’s heel and squeezing firmly on the sides. This will place pressure on the growth plate and in turn immediately result in discomfort for the child.
At-Home Treatment For Sever's Disease
Dr. Jarman’s at-home guide for Sever’s disease provides parents with a comprehensive understanding of the condition, including how to identify common symptoms such as heel pain, limping, and stiffness in children. The guide outlines simple tests that can be done at home, such as the Squeeze Test, and discusses treatment options like rest, stretching, and custom orthotics. It also emphasizes how the Mikki Device™ can provide lasting relief for chronic Sever’s Disease.
Read Dr. Jarman’s At-Home Guide To Identify And Treat Sever’s Disease »
Chronic Sever's Disease - What Every Parent Should Know
How to Diagnose Sever's Disease
Dr. Mikkel Jarman breaks down Sever’s disease (calcaneal apophysitis)—a common, activity-related heel pain in kids—and shows how his custom Mikki Device orthotic relieves it fast.
Affects active kids 7–14, regardless of foot shape
Heel squeeze test confirms pain at the growth plate
Pain flares during “ground-and-pound” sports (soccer, gymnastics, football, etc.)
X-rays may reveal tiny fissures in the heel’s growth center
The Mikki Device neutralizes stress on the growth plate, letting kids stay in the game
Treating Chronic Sever's Disease
Dr. Mikkel Jarman explains how to stop Sever’s heel pain once and for all—especially the stubborn, day-to-day kind that rest and ice can’t touch—using his custom Mikki Device orthotic.
Acute vs. chronic: Rest, ice, and gel heel cups help short-lived flare-ups, but chronic Sever’s needs specialist care.
Why common fixes fail: Pain persists when ground impact and Achilles pull keep stressing the heel growth plate.
Mikki Device advantage: Custom-molded to each foot; redistributes pressure so the plate can heal.
Rapid results: 50-70 % pain relief in 2 weeks; 70-100 % by week 4 when worn in everyday shoes and cleats.
"As a pediatric podiatrist with over a decade of experience, I have treated thousands of young athletes for a common cause of heel pain known as Sever's Disease. Of all the heel pain issues we see in children at our clinic, particularly ones that play sports, Sever’s accounts for over 85% of these cases.
It's important to note, these are Chronic Severs' disease cases. When we talk about Severs' disease treatment, we are referring to chronic since Acute Severs will generally resolve on its own and does not require treatment.
The underlying cause involves inflammation from repetitive stress to the heel. It most often occurs during the child’s growth spurt, a phase when bones, muscles, and tendons are developing and changing rapidly. For girls this is generally between the ages of six to thirteen, and boys between the ages of ten to sixteen. This condition is much more prevalent in children that play what I refer to as 'ground and pound' sports like soccer, gymnatics, and other similar activities."
The Difference Between Acute & Chronic (and why it matters)
Acute Sever's
Acute Sever’s is the milder of the two, and will either resolve on its own, or respond very well to conservative treatments like:
- Elevating the leg and applying ice (not directly on the skin) for 15 to 20 minutes 3 times a day.
- Over-the-counter medications like Acetaminophen (Tylenol) or Ibuprofen (Advil and Motrin), not aspirin.
- Rest and ceasing “ground and pound” activities like running, soccer, and gymnastics for two to four weeks.
Almost every young athlete will experience some heel pain from acute Sever’s, but you generally do not need to seek medical care for acute cases. If the child’s heel pain doesn’t resolve on its own and is constant, it is most likely chronic.
Chronic Sever's
Chronic Sever’s is more serious, and as the name implies, is an ongoing condition that affects the child every day even when they are not active. Chronic doesn’t respond to conservative treatments, and a custom orthotic fabricated from the child’s foot specifically is considered the best treatment option.
A custom orthotic:
- Is cast specifically from your child’s foot for a precise fit and maximum effectiveness.
- Is a heel cup that evenly distributes the weight taking the pressure off the heel plate allowing it to heal.
- Is generally prescribed with a nighttime splint to keep the tendons and muscles from tightening back up in the night.
- Learn More About Treating Chronic Sever’s Disease with the Mikki Device
When 11-year-old Max suddenly could barely walk on his heel, months of urgent-care visits, ice baths, and specialist appointments left his family frustrated and Max still in pain. They spend far too many hours with doctors that didn’t understand chronic Sever’s Disease. It wasn’t until they discovered Dr. Mikkel Jarman and the Mikki Device that Max finally found fast, lasting relief from chronic Sever’s disease (calcaneal apophysitis).
In this video you’ll learn: ✅ Why Sever’s disease is the #1 heel pain culprit in active kids ages 8-14 ✅ How the Mikki Device off-loads the growth plate so it can heal ✅ The simple fitting process and what to expect during recovery ✅ Dad’s advice to parents: skip the “doctor hop” and see a pediatric foot specialist first
Join the Sever’s Disease Support Community
Connect with parents, share experiences, and get expert guidance from Dr. Jarman in our dedicated Facebook group.
Sever's Disease Custom Orthotic Available Without A Doctor Visit or Prescription
The Mikki Device™
The Mikki Device™ is a custom orthotic shoe insert designed by a pediatric podiatrist to specifically treat Sever’s disease in children. Even when other Sever’s treatment options have failed, the Mikki Device™ has proven effective in over 97% of the children who use it.
Sever's Disease Treatment Success Stories
Gracie’s mom shares her and Gracie’s experience with Sever’s disease. She watched her daughter go from being an active healthy kid to starting to walk on her tippy toes, to eventually having to get a wheelchair.
Ryan began feeling pain in his left heel about a year ago. As time went by the heel pain became more frequent and painful and his parents knew it was time to see a doctor.
Jackson is an active kid who loves playing sports, particularly soccer. When he began experiencing heel pain it became difficult to participate in practices or games and his mom began noticing him limp and difficulty walking even off the field.
Nicholas’s mom suspected something was wrong with Nicholas’s feet when he started experiencing heel pain playing soccer.
Causes of Sever’s Disease
The following conditions may increase your child’s chances of contracting Sever’s disease.
- A child’s growth spurt between the ages of 8 to 15.
- Ground and pound sports like soccer, running, dance, or gymnastics
- A pronated foot, or a foot that rolls at the ankle when walking. This may cause a twisting and tightness of the Achilles tendon, which increases the pull on the heel’s growth plate.
- High or flat arches, which can affect the heel’s angle within the foot.
- A tight achilles tendon.
- Being overweight or suffering from obesity, which may put additional pressure on the growth plate.
- Short leg syndrome. This is when one leg is shorter than the other one. Thus forcing the shorter leg to bend down in order to reach the ground.
Adult heel pain and Children’s heel pain are not the same and are treated differently.
Symptoms of Sever's Disease
A child’s change in walking or abnormal gait due to tenderness and pain in either one or both heels is the most obvious sign of Sever’s disease. This usually occurs in the back. However, it is possible for the pain to also go down the sides and the bottom of the heel, right around the arch of the foot.
Other symptoms and problems of Sever's Disease may include:
- Difficulty with walking
- Discomfort if the heel is squeezed on both sides
- Redness or swelling of the heel
- When walking, the feet are stiff or discomforted
- Walking unusually, to avoid putting pressure on the heel by walking on one’s tiptoes or with a limp.
Sever's Disease FAQ's
Sever’s disease is a painful inflammation of the growth plate in the heel bone of children, caused by excessive tension and repetitive stress on the heel.
The main symptoms are pain and tenderness in the heel and arch area. Swelling around the heel may also occur.
It is caused by repetitive micro-tears to the Achilles tendon where it attaches to the growth plate in the heel. Sports that involve running and jumping put added stress on the heel.
Sever’s disease typically affects active children between the ages of 8-15 years old. It is more common in boys than girls.
Traditional treatments include rest, ice, stretching, over-the-counter anti-inflammatories, and supportive shoe inserts. The Mikki Device offers an additional treatment option.
Limiting repetitive high-impact activities, using cushioned heel pads, stretching the calf muscles, and having regular foot exams during growth spurts can help prevent Sever’s disease.
Limiting activity is sometimes needed to allow the heel to rest and recover. However, The Mikki Device allows participation in sports to continue while treating Sever’s Disease at the same time.
Yes, Sever’s disease resolves itself once the heel bone stops growing. This may take 1-2 years in most kids.
It is possible to have recurrent episodes of Sever’s disease until growth plates close in the early teen years. Using preventive measures can reduce reoccurrence.
No, Sever’s disease does not lead to any long-term complications once the condition resolves as the child’s heel finishes growing.
Your Child's Feet Are Designed For Life
