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UW Health SMPH
American Family Children's Hospital

Calcaneal Apophysitis (Sever's Disease)

UW Health's Sports Medicine doctors in Madison, Wisconsin, treat a wide range of common athletic injuries, including calcaneal apophysitis, or Sever's disease.


About Calcaneal Apophysitis (Sever’s Disease)


Calcaneal apophysitis (Sever’s disease) is the most common cause of heel pain in young athletes. It is a painful inflammation of the heel’s calcaneal apophysis growth plate, believed to be caused by repetitive microtrauma from the pull of the Achilles tendon on the apophysis. Patients with calcaneal apophysitis may have activity-related pain in the back part of the heel. Sixty percent of patients report pain in both heels.


This condition is usually treated conservatively with calf stretching and arch supports. Some athletes’ calves are so tight that heel lifts may be indicated. The young athlete should be able to return to normal activities as the pain decreases. Calcaneal apophysitis may last for months. Increasing pain, despite trying the listed treatment recommendations, warrants a return visit to the physician.


Signs and Symptoms

  • Heel pain on one or both sides
  • Heel pain with running, jumping and other sport-related activities
  • Limping
  • Pain elicited when the heel is squeezed


  • Sports with running and jumping
  • Poor footwear
  • Tight lower leg muscles, primarily the Achilles tendon and the calf
  • Normal growth pattern when the bones often grow faster than the muscles and tendons


  • Reduce sporting activities as needed based on pain
  • Ice after activity
  • Stretch hamstrings, calves and Achilles tendons for 15-20 minutes
  • Evaluate for orthotics, arch supports and/or new shoes
  • Heel lifts or non-custom arch supports
  • Avoid going barefoot
  • Anti-inflammatory/analgesic medication as needed for pain