Calcaneal apophysitis, also known as Sever's disease, is a common cause of heel pain in growing children, particularly those who are physically active. It involves inflammation of the growth plate in the heel (calcaneus). This condition is most frequently observed in children between the ages of 8 and 14 years old, because the heel bone (calcaneus) is not fully developed until at least age 14. Until the bone is fully formed, new bone is developing at the growth plate (physis), a weak area located at the back of the heel.

The main symptoms of calcaneal apophysitis include:

• Pain in the heel, which may be worsened by physical activity such as running or jumping.

• Tenderness at the back of the heel that worsens with pressure.

• Swelling and redness in the heel.

• Walking with a limp or walking on tiptoes to avoid putting pressure on the heel.

The condition is thought to be caused by repetitive stress to the heel's growth plate due to physical activity and sports, combined with the stress of the Achilles tendon at its attachment point on the growth plate. This repetitive stress can lead to inflammation and pain.

The treatment for calcaneal apophysitis is generally non-surgical and focuses on alleviating pain and reducing inflammation. Recommendations may include:

• Rest and avoidance of activities that exacerbate pain.

• Ice application to reduce pain and swelling.

• Over-the-counter pain relief medications, such as ibuprofen or acetaminophen.

• Stretching exercises for the calf muscles to reduce tension on the Achilles tendon.

• Shoe inserts or orthotic devices to provide support to the heel and foot.

Most children with calcaneal apophysitis find that their symptoms improve with these conservative measures. The condition typically resolves with time, particularly once the growth plate in the heel has fully matured.