Why does Sever's disease cause heel pain?

The heel bone has a growth area that remains active during childhood and adolescence. The Achilles tendon connects the calf to the heel, so each stride, sprint and jump transfers force through this region. When training, surfaces, footwear or tight calf muscles add repeated load, the area can become irritated. Pain is often felt at the back of the heel and may worsen after activity or when the heel is squeezed. It can affect one or both sides and may improve when the load is reduced.

Temporarily replace painful running and jumping with comfortable low-impact movement. Wear well-fitting, supportive shoes and consider a cushioned heel insert if a clinician agrees. Gentle calf flexibility work may be useful, but stop if it increases heel pain. Ice wrapped in cloth after activity can provide short-term comfort. Resume sport in stages once ordinary walking is comfortable, and allow symptoms to guide the pace.

See a clinician when heel pain persists, repeatedly limits sport, causes a limp, or is difficult to localise. Get urgent help if the child cannot bear weight, has severe pain after an injury, significant swelling, warmth, redness, fever, or new numbness. These features need assessment because other heel or bone problems can look similar.

Ask which activities are safe now, whether the calf and Achilles tendon are contributing, and whether a heel insert or physiotherapy would help. Ask for a clear step-by-step return-to-sport plan.