Sever's Disease: How Long Heel Pain in Kids Lasts and What Helps
What is going on in a growing heel, how long it really lasts, how much sport is OK, and the signs that point to something other than Sever's.
Sever's disease is the most common cause of heel pain in active children, and despite the name it is not really a disease. It is irritation of the growth plate at the back of the heel bone, where the Achilles tendon pulls with every sprint and jump. It usually settles within 2 weeks to 2 months of easing off, can flare again while your child is still growing, and stops for good once that growth plate turns to solid bone, around age 15 to 16.
Below: how to recognize it, a realistic timeline, what actually helps, how much sport is OK, and the signs that mean your child's heel pain is something else.
ASG Foot & Ankle patient education. Updated October 27, 2026. General information, not a diagnosis.
The short answer
Sever's disease (calcaneal apophysitis) usually settles within about 2 weeks to 2 months once your child cuts back on the running and jumping that hurts; in a 10-year study of youth soccer players, the average return to full training took about 8 to 9 weeks. It can flare again with growth spurts or a new season, on and off for 6 to 12 months and occasionally up to 2 years, but it ends for good when the heel growth plate closes, usually around age 15 in girls and 16 in boys. It leaves no lasting damage, and many children can keep playing at a lower level while it settles.
Get It Seen Promptly If
Sever's pain follows a pattern: at the back or bottom of the heel, worse with activity, better with rest. Pain that breaks the pattern needs an examination. Get same-day care if your child:
- •Has a fever or seems generally unwell along with the heel pain
- •Cannot put weight on the foot
- •Hurt it in a specific fall, twist or landing, and one spot is sharply tender or swollen
- •Has severe pain, pain that wakes them at night, or a limp on days with no sport at all
Book an appointment soon if:
- •The pain is somewhere unusual, such as the arch, the ankle, or the tendon above the heel
- •Nothing has improved after about 6 weeks of following the advice below
- •Your teen has finished growing and still has heel pain
- •Your child has a history of cancer
- •Your child has diabetes, or any condition that affects feeling or circulation in the feet
What Is Sever's Disease? Calcaneal Apophysitis Explained
The back of a child's heel bone has a growth plate, called the apophysis: a band of cartilage where new bone is still forming. Until it closes, it is weaker than the tendons and ligaments around it. The Achilles tendon, the strong cord from the calf muscles, attaches right there.
During a growth spurt the bones can lengthen faster than the muscles and tendons, which leaves the calf and Achilles tight. Every sprint, jump and landing then tugs on that soft growing area, and with enough repetition it becomes inflamed and sore. That is Sever's disease: an overuse irritation of a growth plate, not an infection and not arthritis. Children with Sever's recover completely, with no long-term problems.
Who gets it
Ages 8 to 14
It is most common between about 8 and 14, around the growth spurt. The average age at diagnosis is about 11 to 12, and it is seen more often in boys.
Running and jumping sports
Soccer, basketball, gymnastics and track, especially on hard surfaces. Specializing early in a single sport adds to the risk.
A sudden jump in training
Flares cluster in the first months of a season and after a winter break, when training ramps up quickly.
Tight calves, flat feet, flat shoes
Tight calf muscles, flat feet and carrying extra weight all add strain. Less active teens can get it too, especially in very flat shoes.
Symptoms: My Child's Heel Hurts After Sports
The typical story is a child of 8 to 14 who starts limping off the field, complains that the back of the heel hurts after practice, and is fine again after a rest. Common signs:
- Pain at the back or bottom of the heel, sometimes spreading a little into the calf or the sole
- Worse during or after running and jumping, better with rest
- Limping, or walking on tiptoes to keep weight off the heel, especially after sport
- Stiffness first thing in the morning
- Pain when the heel is squeezed from both sides
- Sometimes mild swelling or redness at the heel
- One heel or both: about 60% of children in one NHS hospital's experience have it in both feet
The squeeze test
Clinicians check for Sever's by squeezing the back of the heel bone from the inner and outer sides at the same time. With Sever's, this is tender. They also press where the Achilles attaches, check how tight the calves are, and sometimes watch your child walk, run or jump.
You can gently try it at home: cup the back of the heel between your thumb and fingers and press in from both sides. If that reproduces the pain your child gets after sport, Sever's is likely. It is a clue, not a diagnosis, and it cannot rule out other heel problems.
Does it need an X-ray?
Usually not. Sever's disease is diagnosed from the history and the examination, and X-rays of an affected heel usually look much like a healthy one. An X-ray, or sometimes another scan, is used to rule out other causes, such as a fracture, when the story does not fit the usual pattern.
How Long Does Sever's Disease Last?
Two clocks are running: how long a single flare takes to settle, and how long your child stays prone to flares. The first is usually weeks. The second lasts until the heel stops growing.
| Milestone | Typical timing |
|---|---|
| A single flare, once impact is reduced | About 2 weeks to 2 months |
| Back to full training (soccer academy study average) | About 8 to 9 weeks, ranging from 2 weeks to about 10 months |
| Both heels affected, or a repeat bout | Often several months |
| Prone to flares on and off | Often 6 to 12 months, sometimes up to 2 years |
| Over for good: growth plate closes | Around age 15 in girls, 16 in boys |
A Flare, Stage by Stage
Ease Off, Ice, Cushion
- Cut back the running and jumping that hurts; walking, swimming and cycling are usually fine
- Ice the heel for 10 to 15 minutes after activity, with a cloth between the ice and the skin
- Cushioned heel cups in sports and school shoes, and daily calf stretches from day one
Settling
- Many children keep playing at a lower level, as long as pain stays at 3 out of 10 or less and settles quickly
- The limp and morning stiffness should fade as the flare calms down
- Add calf strengthening once the stretches feel easier
Check-In Point
- No improvement at all after about 6 weeks of following the plan is a reason to have it reviewed
- In one 10-year study, young athletes were back to full training after about 8 to 9 weeks on average
Flares Can Come Back
- A growth spurt, a new season or dropping the stretches can bring it back
- Keep stretching through the growing years and build training up gradually
- Symptoms coming and going is normal and does not mean treatment has failed
The Growth Plate Closes
- The growth area fuses into solid bone and Sever's disease cannot return
- It leaves no long-term problems
What makes it last longer
A German youth soccer academy reviewed every case over 10 years. Players averaged about 61 days out of full training, but the range ran from 2 weeks to about 10 months. Two things stood out: players with both heels affected averaged about 7 months, against about 6 to 7 weeks with one heel, and a repeat bout averaged about 6 months, against about 6 weeks for a first one. Age and weight made no difference.
It was a small group of 19 players, so treat it as a direction rather than a forecast. The practical lesson: settle the first flare properly and build back gradually, because a heel that keeps getting re-irritated takes much longer.
What Age Does Sever's Disease Stop?
Sever's disease ends when the heel growth plate fuses with the rest of the heel bone. One NHS children's orthopedic service puts that at around 15 for girls and 16 for boys; other children's health guides say by about 15. Once it has fused, the soft growing area is gone, so Sever's cannot come back. Until then, symptoms coming and going is normal.
It works the other way too: Sever's is a diagnosis for growing children. Heel pain that persists in an older teen who has finished growing deserves a proper look, because the likely causes change to adult ones, such as Achilles tendonitis, plantar fasciitis or a stress fracture.
Sever's Disease Treatment: What Actually Helps
There is no single cure, and the simple measures are the treatment. The aim is to calm the growth plate down while keeping your child active and involved.
Ease off, do not stop
Cut back the activities that hurt rather than all activity. Walking, swimming and cycling are usually fine. A few children with severe pain need more complete rest for a longer spell.
Ice after activity
10 to 15 minutes at a time, with a cloth or towel between the ice and the skin, after sport and on sore days.
Heel cups or small heel raises
Cushioned gel heel cups, heel pads or a small heel raise soften each landing and take some stress off the heel bone. Family medicine guidance suggests heel cups early on.
Daily calf stretches
Tight calves add to the tug on the growth plate. One NHS service notes that stretching eases symptoms and cuts repeat flares if kept up through the growing years.
Supportive, cushioned shoes
Well-fitting shoes with padded soles. Avoid very flat or heavy shoes. Shoes that are open at the back can be more comfortable around the house.
Pain relief if needed
Ibuprofen or acetaminophen, following the package directions, on sore days. It eases pain but does not replace cutting back the impact.
A simple daily stretching routine
Most of these can be done while brushing teeth. Hold each stretch for at least 30 seconds, repeat it 3 times on each leg, and do at least two of them every day:
- 1Wall calf stretch. Face a wall with hands on it, step one foot well back, keep that knee straight and the heel on the floor, and lean in until the calf feels a stretch.
- 2Bent-knee calf stretch. Same position, then bend the back knee slightly while keeping the heel down. The stretch moves lower in the calf.
- 3Step stretch. Stand on the bottom stair holding the rail, heels hanging off the edge, knees straight, and let the heels sink toward the floor.
A little discomfort while stretching is fine as long as it settles once they stop. When the stretches feel easy, add strength: slow heel raises on a step with both feet, then on one foot. One NHS children's physiotherapy team suggests working up to just under double the child's age in single-leg heel raises on each leg, so about 18 for a 10 year old.
What the research says about heel cups and inserts
In a trial of 124 children aged 8 to 14, simple heel raises improved physical function more than off-the-shelf arch supports at 1 and 2 months. By 6 and 12 months, no option had an advantage, and buying new shoes made no lasting difference either. The researchers suggest choosing on cost and preference.
So start with the inexpensive options. If foot shape, such as flat feet, seems to be adding to the strain, a podiatrist can advise on orthotics; the trade-offs are in custom orthotics vs store insoles.
If it is not settling
Most children do well with the home measures. If several weeks have not helped, a clinician may recheck the diagnosis, arrange physical therapy, or rest the heel in a walking boot. For severe or stubborn pain, a short below-knee cast for about a week is sometimes used to let it calm down.
Can My Child Play With Sever's Disease?
Often, yes. Carrying on with sport is not harmful in itself, but it can make the pain worse, so the real question is how much. Children's physiotherapists at an NHS hospital in Edinburgh give families a simple 0 to 10 pain rule: pain during activity should stay at 3 or below and settle quickly afterward. Staying part of the team matters too, even in a lighter role.
| Signal | What you notice | What to do |
|---|---|---|
| Green | Pain 0 to 3 out of 10 during sport, settles quickly afterward, no limp | Keep playing, perhaps fewer or shorter sessions. Ice and stretch afterward. |
| Amber | Pain above 3 during sport, pain that lingers after stopping, or a limp | Cut back: skip sprints, jumping drills or a match, swim or cycle instead, and find a role with the team. |
| Red | Pain at rest or at night, cannot bear weight, fever, or pain after a specific injury | Stop sport and get it examined. This may not be Sever's disease. |
Getting back to full sport
- Ready when your child can hop, skip and jump without pain
- Walking, swimming and cycling first, then gentle running, then part of a training session
- Add back one activity or training session a week
- Warm up, cool down, and keep stretching
- Tell the coach, so drills can be adapted for a while
Preventing the next flare
- No more than 4 high-intensity sessions a week
- Avoid high-intensity sport on 2 days in a row
- Weekly hours of organized sport no more than your child's age: 12 hours for a 12 year old
- Build back slowly after holidays, injuries and the off-season
Heel Pain in Kids: When It Is Something Else
Sever's disease is the most common cause of heel pain in children and adolescents, but not the only one. Family medicine guidance lists severe pain, an injury, being unable to bear weight, pain in an unusual place, night pain, signs of illness or infection, and a history of cancer as reasons for further checks. Clues that point elsewhere:
| What you notice | What it can point to |
|---|---|
| Fever or feeling generally unwell along with heel pain | An infection in the bone or joint needs ruling out. Same-day care. |
| Pain at night, or at rest, that keeps getting worse | A stress fracture, or, rarely, a tumor. Usually needs imaging. |
| Sudden pain after a fall, twist or awkward landing, with one sharply tender spot | A fracture or sprain rather than a growth plate irritation. |
| Pain and tenderness in the cord above the heel | Irritation of the Achilles tendon itself. |
| A firm bump at the back of the heel that rubs in shoes | Haglund's deformity, the so-called pump bump. |
| Sharp pain under the heel with the first steps of the morning in a teen who has finished growing | Plantar fasciitis, the classic adult heel pain. |
| Painful, swollen joints elsewhere as well | An inflammatory arthritis, which needs a pediatric specialist review. |
A bump at the back of the heel is covered in Haglund's deformity, and pain that builds over weeks until it hurts even at rest in stress fracture healing time. If the heel pain started with a fall or a twist, see broken foot recovery time or the ankle sprain recovery timeline.
If your child has diabetes
If your child has diabetes, or another condition that affects feeling or circulation in the feet, have heel pain examined rather than managing it at home. Reduced feeling can hide an injury, and heel cups or new shoes that rub can cause blisters your child does not notice, so check the skin of both feet daily. More in diabetic foot care.
Heel pain in an adult in the family? The realistic timeline. Plantar Fasciitis Healing Timeline →
Pain in the cord above the heel? Achilles Tendonitis Recovery →
A hard bump on the back of the heel? Haglund's Deformity (Pump Bump) →
Pain that built up and now hurts at rest? Stress Fracture Healing Time →
Choosing inserts? Custom Orthotics vs Store Insoles →
Frequently Asked Questions
How long does Sever's disease last?
A flare usually settles within about 2 weeks to 2 months once your child cuts back on the running and jumping that hurts. In a 10-year study of youth soccer players, the average time out of full training was about 8 to 9 weeks. The condition itself can come and go, often for 6 to 12 months and occasionally up to 2 years, until the heel growth plate closes.
What age does Sever's disease stop?
When the growth plate at the back of the heel bone fuses into solid bone, usually around age 15 in girls and 16 in boys. After that, Sever's disease cannot come back. Heel pain in a teenager who has finished growing is something else, such as an Achilles tendon problem, plantar fasciitis or a stress fracture, and is worth having examined.
Can my child play sports with Sever's disease?
Often, yes, at a lower level. Playing on is not harmful in itself, but it can make the pain worse. One NHS children's hospital uses a simple rule: pain during sport should stay at 3 out of 10 or less and settle quickly afterward. If your child is limping or the pain is building, swap to swimming or cycling for a while, and return once they can hop, skip and jump without pain.
Why does my child's heel hurt after sports?
In children of about 8 to 14, the most common reason is Sever's disease: the Achilles tendon pulling over and over on the growth plate at the back of the heel bone during running and jumping, often during a growth spurt or at the start of a new season. Typical signs are pain during or after activity that eases with rest, limping or walking on tiptoes, and pain when the heel is squeezed from both sides.
What is the fastest way to treat Sever's disease?
There is no quick fix, but the combination that settles most flares is: cut back the running and jumping that hurts, ice the heel for 10 to 15 minutes after activity, use cushioned heel cups or small heel raises, stretch the calves every day, and wear supportive, cushioned shoes rather than very flat ones. Ibuprofen or acetaminophen, at the dose on the package, can help on sore days. Most flares ease within 2 weeks to 2 months.
Do heel cups help Sever's disease?
They can, and they are inexpensive. Family medicine guidance suggests heel cups early on, along with relative rest and calf stretching. In a trial of 124 children aged 8 to 14, simple heel raises improved physical function more than off-the-shelf arch supports at 1 and 2 months, but by 6 and 12 months no option had an advantage. If they do not help, a podiatrist can check whether foot shape is adding to the strain.
Does my child need an X-ray for Sever's disease?
Usually not. Sever's disease is diagnosed from the history and an examination, and X-rays of a painful heel usually look much the same as a healthy one. An X-ray or other scan is worth doing when something does not fit: pain after a specific injury, pain at night or at rest, a fever, a heel that is not improving with treatment, or heel pain in a teenager who has finished growing.
Sources and further reading
- AAOS OrthoInfo: Sever's disease
- Nemours KidsHealth: Sever's disease (for parents)
- Cleveland Clinic: Sever's disease (calcaneal apophysitis)
- American Family Physician: Apophysitis and osteochondrosis, common causes of pain in growing bones (2019)
- American Family Physician: Diagnosis of heel pain (2011)
- Royal Berkshire NHS Foundation Trust: Sever's apophysitis of the heel (2025)
- NHS Lothian, Royal Hospital for Children and Young People: Sever's disease information booklet
- West Suffolk NHS Foundation Trust: Sever's disease
- Belikan P et al. Incidence of calcaneal apophysitis and return to play in a youth soccer academy over 10 years. J Orthop Surg Res (2022)
- James AM, Williams CM, Haines TP. Footwear and foot orthoses for calcaneal apophysitis: a 12-month factorial randomised trial. Br J Sports Med (2016)
General patient education. Your child's examination and individual treatment instructions take priority.
See a Podiatrist Near You
ASG Foot & Ankle has offices in Homewood, South Chicago Heights and Mokena. Our board-certified podiatrists accept most insurance. Find the office closest to you:
Heel Pain Keeping Your Child Off the Field?
ASG Foot & Ankle can examine your child's heel, tell Sever's disease from a problem that needs an X-ray, and set up a plan for heel cups, stretching and a safe return to sport, with extra care when diabetes is part of the picture.