What should you know about heel support for Sever's disease?

Sever's disease, also called calcaneal apophysitis, affects the growing area at the back of the heel. Repeated running and jumping can load this area while the child is growing, causing activity-related heel pain, tenderness, or a limp. The condition is not caused by a child choosing the wrong shoe. A heel cup or cushioned insert can reduce impact and may make walking or sport more comfortable, but it does not change the growth area itself.

Choose secure, well-fitting sports shoes and introduce a heel cup gradually. Reduce running, jumping, and training sessions that trigger pain; low-impact activity may be acceptable when comfortable. Gentle calf stretching and strengthening can be included when recommended. Custom orthotics are not automatically needed, but a clinician may consider them if foot mechanics add strain. Paediatric physiotherapy can help the child, family, and coach plan a gradual return to activity.

Seek assessment if heel pain causes limping, interrupts sleep, persists during rest, or does not settle after activity is reduced. Prompt care is needed after an injury, when the child cannot bear weight, or when there is substantial swelling, redness, fever, numbness, or unusual colour change. Another cause of heel pain may need to be considered.

How much activity can my child safely do now? Would a heel cup or custom orthotic fit their shoes? Which stretches are suitable? What should the coach know about a gradual return?