Pain in the back of the foot of children is not very common, however when it does happen the most common reason is a problem known as Severs disease. It’s not really a “disease”, but it is the label that is unfortunately widely and commonly used. It is properly named calcaneal apophysitis. It is a issue in the growing region at the back of the heel bone. Because it is a problem, of the growing bone, the problem is self-limiting and will not be an issue once the growth of that bone has concluded. It is more common around the ages of 10-12 years and usually go away by the early teenage years.

The classic characteristic of Severs disease is discomfort on exercise and soreness on squeezing the sides of the back part of the heel bone. Initially the pain is not that bad and doesn’t impact activity very much, but later it becomes more severe and affects exercise levels and can even result in limping. The exact cause of it is not known, but it is certainly an too much use type condition because it is more common in kids who play more sport and more prevalent in children who have got a higher body weight. Kids with tight calf muscles might also be at a greater risk for the chances of this problem.

Typically, treating Severs disease is activity modification. The child is urged to remain active, but just cut back exercise amounts to a level which can be tolerated and not too uncomfortable. A  cushioning heel raise in the footwear might be useful to protect it. Ice after activity might also be useful to help the symptoms. If the leg muscles are tight, then a stretching program needs to be started. Occasionally foot orthotics can be helpful when the arch of the foot is lower. On rare occasions a brace can be utilized, and all sport halted until it gets better. By the mid-teens the growing plate that this occurs at combines with the rest of the heel bone, which means this stops being an issue at those age groups.