What happens at the heel
The back of the heel contains a growth area where the Achilles tendon attaches. Repeated tension and impact can irritate this area. Running and jumping often bring on symptoms, especially during periods of rapid growth. One or both heels may be affected, and the pain can develop without a remembered fall or a single obvious injury.
How the cause is assessed
Assessment considers the child's age, activities, and exact location of pain, alongside examination of the foot, ankle, and calf. X-rays are not necessary in every case and cannot establish Sever's disease on their own. They may be requested when the history or examination raises concern about another cause, such as a fracture.
Adjusting activity may help
Treatment usually focuses on reducing activities that worsen symptoms, checking footwear, and considering cushioning or heel cups. Gentle calf exercises should suit the child's tolerance and should not cause heel pain. Some children can continue modified activity, while others need a temporary break from running and jumping. That decision depends on symptoms and whether the child is walking comfortably.
Signs that need prompt assessment
Inability to bear weight or walk, significant trauma, fever, or marked warmth and redness needs urgent assessment today; do not wait for a routine appointment. Go to an emergency department if the child cannot bear weight or has fever and is generally unwell. Persistent night pain, pain that does not settle with rest or a continuing limp also needs review and should not automatically be attributed to growth.
Planning a return to sport
Symptoms may recur when activity increases during growth. Returning should be gradual and adjusted to the child's response. Before an appointment, note what happens during practice, afterward, and the following morning. Include recent changes in footwear and how often the child trains or plays.
Ask which activities can continue, which exercises are appropriate, and what changes mean the plan needs adjusting. Sharing this guidance with the coach helps turn the advice into a practical participation plan. The next match date alone should not decide when the child returns to their usual level of activity.