A parent’s guide from Bayshore Podiatry Center in South Tampa.
Quick take
- The most common heel pain pattern in active kids is an overuse problem at a growth area, often called Sever’s disease (calcaneal apophysitis).
- The solution is usually load management plus support and flexibility—not “pushing through.”
- Persistent limping, swelling, or pain at rest deserves evaluation.
Table of contents
- Why kids get heel pain
- Sever’s disease: what it looks like
- Other causes of heel pain (quick overview)
- What you can do at home (first 10–14 days)
- When to be evaluated
- How we evaluate heel pain
- Treatment options (least to most invasive)
- Prevention tips for active kids
- FAQs
- Sources
Why kids get heel pain
Children’s feet have growth areas that are more sensitive to repetitive pulling and impact than adult bone. When training volume jumps, sports seasons ramp up, or shoes change (cleats are a common trigger), the heel can become painful.
The key concept is tissue stress: the heel is receiving more stress than it can currently tolerate.
Sever’s disease (calcaneal apophysitis): what it looks like
This is a common pattern in school-age kids and teens who run and jump.
Symptoms parents notice
- Heel pain during or after sports
- Limping after practice or games
- Pain that improves with rest and returns with activity
- Sometimes pain with squeezing the sides of the heel
What’s reassuring
- No fever, no major swelling, no bruising
- Pain tied to activity
- Improvement when impact is reduced
What’s not reassuring
- Pain at rest or at night
- Significant swelling, redness, or warmth
- Pain after a specific traumatic event
- Inability to bear weight
Other causes of heel pain (quick overview)
Not every heel hurts because of Sever’s. A clinician may consider:
- Achilles tendon irritation (higher in the heel, often tighter calves)
- Plantar fascia irritation (more under the heel/arch)
- Bone stress injury (especially if pain is very focal and worsens with impact)
- Infection or inflammatory conditions (rare, but high-stakes)
- Nerve irritation (uncommon in typical kids, but possible)
You do not need to self-diagnose which one this is. Your job is to notice the pattern, reduce the load, and seek care if it is not improving.
What you can do at home (first 10–14 days)
1) Reduce impact temporarily
This is the biggest lever. Replace running and jumping with lower-impact movement for a short window. Most kids can keep moving without making the heel worse.
2) Support the heel
- Supportive shoes for daily wear
- Heel cushion or heel cup
- Avoid barefoot time during flares
3) Stretch and restore capacity
- Gentle calf stretching
- Simple strength work that doesn’t spike pain (for older kids, a clinician can guide progressions)
4) Calm symptoms
Ice after activity can help. Pain medication decisions should follow your pediatrician’s guidance.
A useful rule of thumb
If your child is limping, the heel is not ready for impact that day.
When to be evaluated
Book an evaluation if:
- Limping persists
- Pain keeps returning the moment sports resume
- Pain is significant enough to change how your child moves
- Symptoms are not improving with a short period of load reduction and support
- There are red flags (rest pain, swelling, fever, trauma, inability to bear weight)
Book your kids evaluation here
How we evaluate heel pain in clinic
History
- Sport, training schedule, and recent changes (new season, growth spurt, new shoes)
- Where the pain is and what triggers it
- Any trauma or systemic symptoms
Exam
- Pinpoint tenderness location
- Calf/Achilles tightness
- Gait and functional movement
- Foot mechanics contributing to stress
Imaging
Not every child needs imaging. Decisions depend on the story and exam, especially to rule out fracture or other less common causes.
Treatment options (least to most invasive)
1) Education and activity modification
This is the foundation. Many cases improve when we manage load early. Usually we start some stretching and strengthening exercises to stop the pain and prevent recurrence. Some of those can be found here on our plantar fasciitis treatment videos. They work for kids too!
2) Support
- Shoe recommendations based on fit and comfort
- Heel cushions or inserts for symptom control. You can read more about our approach to the use of orthotics here
3) Rehab plan
Flexibility and strength matter, especially if this keeps recurring.
4) Short-term immobilization (selected cases)
If pain is severe or your child cannot walk without limping, short-term protection may be appropriate.
Prevention tips for active kids
- Avoid sudden spikes in training volume.
- Rotate impact days with lower-impact days during busy seasons.
- Replace worn-out shoes and ensure proper fit.
- Address calf tightness early.
- Treat pain as a signal to adjust load, not as something to “push through.”
FAQs
How long does Sever’s last?
It often improves with proper load management, but it can flare during growth spurts or heavy sports seasons. The goal is to reduce flare frequency and keep your child active safely.
Do we need to stop sports completely?
Often no. We usually modify impact temporarily and create a plan to return gradually.
Are heel lifts “bad”?
Not necessarily. They can be a reasonable short-term comfort tool while the tissue calms down and capacity is rebuilt. Gel heel cups such as these are an excellent first step!
When to book an evaluation
If your child has persistent heel pain or keeps flaring every time sports resume, we can create a clear plan to get them back to activity safely. Book a visit here!
Bayshore Podiatry Center serves families all over the bay area conveniently located in South Tampa near Hyde Park.
Medical disclaimer
This information is for educational purposes only. Seek urgent care for severe pain after injury, inability to bear weight, fever, significant swelling, or rest/night pain.
Sources
- NCBI StatPearls: Sever Disease
- AAOS OrthoInfo: Sever’s Disease
