KEY TAKEAWAYS
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Sever's disease, a common cause of heel pain in children, develops when the heel bone grows faster than the Achilles tendon, creating stress at the growth plate during high-impact activities.
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Increased training volume, multiple sports at once, worn-out footwear, and shifting surfaces all converge at the start of summer to overload a still-developing growth plate.
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With proper evaluation, activity adjustments, and conservative care, most young athletes can stay active while the growth plate heals.
Your child scored a goal in Saturday's soccer game, then spent Sunday limping around the house. Rest helped a little until Monday's practice brought the heel pain right back. If this pattern sounds familiar, there's a good chance the culprit isn't a sprain or a bruise. Heel pain that returns with activity, season after season, is one of the most common complaints podiatrists hear from the parents of young athletes.
The pediatric podiatrists at Marvel Foot & Ankle Centers work with active kids throughout the East Valley whose growing feet need more than rest and wishful thinking. When a child keeps coming home from practice with sore heels, a thorough evaluation can identify exactly what's happening and get them back on the field without the setback cycle. Getting answers early makes a meaningful difference.
What Is Sever's Disease and Why Does It Strike in Summer?
Despite its alarming name, Sever's disease is not actually a disease. It is an overuse injury affecting the growth plate at the back of the heel, and it is one of the leading causes of heel pain in children between the ages of 8 and 14. The condition develops when the heel bone grows faster than the Achilles tendon can handle, creating tightness and stress at the point where the tendon attaches to the heel. Repetitive impact from running, jumping, and cutting movements aggravates that vulnerable attachment site, producing pain that ranges from a dull ache to a sharp, localized soreness.
Summer accelerates the problem. When school lets out, kids who played a single sport suddenly pick up two or three. Practice schedules intensify. Running surfaces shift from gym floors to grass, dirt, and asphalt. Footwear that worked fine during a lower-activity school year may not provide adequate support for higher athletic demands. All of these seasonal changes converge on a growth plate that simply isn't ready for the jump in load.
Why Growing Kids Are Particularly Vulnerable
Growth plates are areas of developing cartilage near the ends of long bones. They are the last part of a bone to harden, making them softer and more susceptible to stress than the surrounding tissue. During growth spurts, bones can lengthen faster than muscles and tendons stretch, pulling at attachment points with every step. For active kids, that pulling is relentless.
Boys tend to develop Sever's disease slightly more often than girls, largely because they tend to enter their growth spurts a little later and spend more of their peak growth months playing high-impact sports. That said, girls who participate in soccer, gymnastics, basketball, and track are equally at risk. The growth plate typically closes between ages 12 and 15, after which Sever's disease resolves on its own.
What Symptoms Should Parents Watch For?
Heel pain in kids often gets dismissed as general soreness, growing pains, or ordinary post-practice fatigue. Sever's disease, however, has patterns that set it apart from routine muscle ache. Knowing what to look for helps parents decide when a pediatric podiatrist visit is warranted.
Watch for these signs in your young athlete:
- Pain in the back or bottom of one or both heels. Sever's disease typically produces localized tenderness right at the heel, not in the arch or ankle. The discomfort may affect one or both feet, and it often worsens when the sides of the heel are squeezed (podiatrists use this as a clinical test during evaluation).
- Pain that spikes during or after activity. Unlike a bruise or minor strain, the heel pain from Sever's disease intensifies with running and jumping, then eases somewhat with rest. Kids may finish practice in significant pain but feel better by the next morning, only for it to return at the next session.
- Limping or altered gait. When heel contact becomes painful enough, children naturally shift weight to the front of the foot to avoid it. Toe-walking, limping, or an obviously changed running style can be the first visible sign that something is wrong.
- Stiffness in the morning or after sitting. Just as with plantar fasciitis in adults, Sever's disease can cause tightness with the first steps after rest. If your child hobbles out of bed or winces getting up from a chair, that morning stiffness matters.
- Reluctance to participate. When a child who normally loves practice starts making excuses to skip, heel pain may be the reason. Kids often underreport pain rather than risk being pulled from a team.
When Should Your Child See a Podiatrist?
Some mild heel soreness after an unusually hard practice may resolve with a day or two of rest, ice, and reduced activity. The key distinction is pattern: if the pain keeps returning whenever your child plays, intensifies over the course of the season, or is severe enough to change how they move, a professional evaluation is the right call.
A podiatrist can diagnose Sever's disease through a physical examination and, when indicated, imaging to rule out stress fractures and other causes of heel pain in young athletes. Treatment is typically conservative. Rest modifications, heel cup orthotics, targeted stretching for the calf and Achilles, and activity adjustments allow the irritated growth plate to settle while keeping the child as active as safely possible. Anti-inflammatory measures can help manage discomfort during recovery.
The goal is not to bench your young athlete for the whole summer. It is to keep them playing without compounding an injury that, left unaddressed, can sideline them for far longer.
How to Reduce Your Child's Risk During Summer Sports Season
Prevention works best when it starts before symptoms appear, particularly for kids who have had heel pain in prior seasons. A few practical habits go a long way:
- Ensure athletic footwear fits well and matches the sport. Worn-out cleats or sneakers that lack heel cushioning are a common contributing factor. Replace footwear before the season starts, rather than after pain develops.
- Stretch before and after. Encourage your child to do light calf and Achilles stretching before and after each practice. A brief warm-up that includes gentle heel drops and calf stretches reduces Achilles tension at the growth plate attachment site.
- Avoid too much too soon. Be cautious about dramatic increases in training volume at the start of summer. Ramping up gradually gives growing bodies time to adapt.
Marvel Foot & Ankle Centers offers pediatric foot and ankle care for young athletes throughout Gilbert, Chandler, and the surrounding East Valley. When heel pain keeps your child off the field, our team can pinpoint the cause and develop a plan to get them back to the sport they love.