Children's heels grow by laying down cartilage on the back of the heel. This cartilage gradually hardens to become bone. When the child grows rapidly the cartilage is very thick and is easily damaged, this is called Sever's disease.
The condition will always resolve itself as the child gets older but this may take two years or more. The objective of treatment is to keeep the child active and relatively pain free during this period.
The cartilage on the back of the heel can be irritated by two sources. The first is the ground or shoe, striking on the bottom of the heel. The second is the Achilles tendon, tugging on its attachment point on the back of the heel.
The goal of treatment is to reduce the pain so that the child can continue to do the activities they enjoy. The podiatrist needs to determine what is contributing to the irritation. Is it the ground striking the bottom of the heel, or is it the Achille's tendon tugging on the heel? The podiatrist will then decide if the child is best treated using a change in footwear, padding, orthotics, or a combination of these.