Your child comes home from football, a CCA session or a holiday sports camp and starts limping. By the next morning, they are walking on their toes to avoid putting weight on their heels. They say it is "just a bit sore", but it keeps happening.
If this sounds familiar, your child may have Sever's disease. It sounds worrying, but it is common, temporary, and very manageable. We asked Ms Ng Jia Lin, Principal Podiatrist at Physio & Sole Clinic, to explain what it is and how the right shoes can help.
What is Sever's disease?
Despite the name, Sever's disease is not really a disease. It is irritation of the growth plate at the back of the heel bone, where the Achilles tendon attaches. Its medical name is calcaneal apophysitis.
"During a growth spurt, the heel bone can grow faster than the calf muscles and Achilles tendon," explains Ms Ng. "That puts extra pull on the growth plate, and running and jumping on top of that makes it sore."
It usually affects boys aged 10 to 14 and girls aged 8 to 12, and it is one of the most common causes of heel pain in children. The good news is that it goes away once the growth plate matures, and most children make a full recovery.
Signs to look out for
- Heel pain during or after running and jumping
- Limping, or walking on tiptoes, after sport
- Pain when you gently squeeze both sides of the heel
- Stiffness in the heels, especially first thing in the morning
- Losing interest in sport or active play because it hurts
"It often affects both heels," says Ms Ng. "Many parents put it down to growing pains, but growing pains usually affect the legs at night, not the heels during activity." For a fuller picture, Physio & Sole Clinic has a detailed guide to Sever's disease.
Why does it happen?
A few things tend to come together:
- A growth spurt. Bones grow faster than muscles and tendons can keep up.
- Lots of running and jumping. Football, basketball, athletics, gymnastics and dance are common triggers.
- Hard surfaces. School fields, courts, and running tracks add impact with every step.
- Busy schedules. Several CCAs, sports classes or a holiday camp in the same week leave little time to recover.
- Worn-out or unsupportive shoes. Shoes with flattened cushioning or a soft, collapsing heel give the heel less protection.
Our earlier piece on preparing your child's feet for active days has more on building up activity gradually.
How shoes can help
Shoes cannot cure Sever's disease, but the right pair takes pressure off the heel while it settles. Ms Ng suggests looking for:
- A cushioned heel to absorb some of the impact of running and jumping.
- A firm heel counter that holds the heel steady and does not collapse when squeezed.
- A slight heel-to-toe drop. A small rise under the heel eases the pull of the Achilles tendon. Completely flat shoes can make it feel worse.
- A secure fit with laces, Velcro, or a dial, so the heel does not slide around.
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The right size. Growth spurts mean shoes can be outgrown quickly, so check their size regularly.
"Barefoot-style shoes are great for building foot strength in healthy feet," says Ms Ng. "But during a flare-up, a cushioned shoe with a little heel support is kinder on a sore heel. Once the pain settles, children can gradually go back to their usual shoes."
It also helps to match shoes to the activity. Our guide to choosing the right shoes for school activities covers what to look for in PE and sports shoes. For school days and weekends, a cushioned pair such as our Basel Air Cushion Sandals is comfortable for long hours on the feet, and our Podiatry Friendly collection brings together styles with firm heels and removable insoles.
If your podiatrist recommends heel cushions or custom insoles, bring them along when shopping and try shoes on with them inside.
What you can do at home
- Cut back, do not stop. Take a break from high-impact sport and swap in gentler activities such as swimming or cycling for a while.
- Ice after activity. Wrap an ice pack in a cloth and hold it on the heel for 10 to 15 minutes.
- Stretch gently. Calf stretches can ease the pull on the heel. Ask a podiatrist or physiotherapist to show your child how.
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Avoid going barefoot on hard floors while the heel is sore.
"With the right care, mild cases often settle in 2 to 4 weeks, and more stubborn ones in 6 to 8 weeks," says Ms Ng. "It can flare up again during the next growth spurt, so it is worth keeping an eye on it."
When to see a podiatrist
Book an assessment if:
- The heel pain lasts more than 2 to 3 weeks, or keeps your child from playing
- Your child is limping even on days without sport
- There is swelling, redness, or pain that wakes them at night
- Only one heel is affected after an injury or fall
A podiatrist will check the heel, watch how your child walks and runs, and ask about their sports and recent growth. Sports podiatrists at Physio & Sole Clinic can put together a plan to keep your child active while the heel recovers. Physio & Sole Clinic also shares more on foot care for active kids.
Conclusion
Sever's disease is a common and temporary cause of heel pain in active, growing children. A short break from high-impact sport, gentle stretches, ice, and cushioned, well-fitting shoes will help most children get back to play. If the pain lingers or stops your child from doing what they love, check in with a podiatrist.
Not sure which shoes will suit your active child? Chat with us on WhatsApp, and we will help you find the right pair.
Use our smart Size Assistant to find out your child's Two Little Feet shoe size, based on their feet length!
Looking for more options?
For babies just starting to walk, check out this curated Wobbly Steps Collection for first walkers who are still walking with support.
If your child is walking steadily, we have curated a Steady Walking Kids Shoes and Sandals Collection.
Have an active running and jumping child at home? Look no further than our most supportive kids sneakers and children sandals for Active Running young ones!
Check out our range of children footwear:
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