Calcaneal Apophysitis (Sever’s Disease)

Calcaneal apophysitis, commonly referred to as Sever’s disease, is a frequent cause of heel pain in physically active children and adolescents. The condition was first named in the early 20th century by James Warren Sever, MD, an American orthopedist. Despite the name, Sever’s is not a true disease; it is neither infectious nor degenerative and does resolve with time.

It is a painful overuse injury related to skeletal immaturity. It occurs at the calcaneal apophysis, located at the posterior aspect of the heel bone, where the Achilles tendon inserts. Sever’s disease is an inflammatory response and mechanical stress reaction at the growth plate of the heel during periods of rapid growth. It is one of the most common musculoskeletal complaints seen in young podiatry patients and pediatric sports medicine.