How effective is custom orthotics for Sever's disease?

Sever's disease is irritation where the growth area at the back of a child's heel is stressed. Running and jumping can increase that load, especially during a period of rapid growth or tight calf muscles. An orthotic may support the foot, reduce strain during each step and add cushioning under the heel. It should be selected for the child's size, footwear, activity and foot movement; it does not stop growth or remove the need to manage painful impact.

Introduce the device for short periods in the shoes used most often, then follow the clinician's progression if the heel remains comfortable. Use supportive footwear, choose lower-impact activity while pain is active and complete the recommended calf or foot exercises. A child should not have to tolerate sharp pain to keep wearing an insert. Check for blisters, pressure at the heel and changes in walking, and arrange a fit review if any appear.

Arrange a medical or physiotherapy assessment if heel pain changes running, walking, sleep or participation, or if it keeps returning after activity resumes. Seek prompt care after a significant injury, when the child cannot bear weight, or when the heel is hot, very swollen, red or associated with fever. A different cause of heel pain may need consideration.

Is the pain consistent with Sever's disease, and what else should be checked? Is cushioning, arch support or both appropriate? Which activities are acceptable now? How should wear change as symptoms improve, and when should the child's growth or fit be reviewed?