Pain in around  the heel area of children isn’t very common, however when it does occur, the commonest cause is a problem called Severs disease. It is not really a “disease”, however it is the label which has unfortunately stuck. It is correctly known as calcaneal apophysitis. It is a issue in the growing region at the back of the heel bone. Because it is a condition, of the growing bone, the problem is self-limiting and definately will no longer be a concern when the growth of that bone has finished. It is more prevalent around the age groups of 10-12 years.

The common sign of Severs disease is discomfort on activity and pain on compressing the sides of the rear part of the heel bone. At first the soreness is minor and will not impact activity very much, but later it becomes more severe and impacts athletic involvement and may even cause limping. The precise reason for it is not known, but it is certainly an excessive use type issue as it is more prevalent in children who play more sport and more prevalent in kids who have a higher bodyweight. Children with tight leg muscles might be at a greater risk for the development of this problem.  

Typically, the management of Severs disease is load management. The child is encouraged to stay active, but just scale back activity levels to a level that can be tolerated and not too painful. A shock absorbing heel raise in the footwear may be helpful to cushion it. Ice after sport can also be helpful to help the pain. If the calves are tight, then a stretching program should be used. Sometimes foot orthotics can be helpful if the arch of the foot is lower. On rare occasions a brace can be used, and all activities stopped until it gets better. By the mid-teens the growth area that this occurs at merges with the rest of the heel bone, so this stops being an issue at those age groups.

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