Severs Disease: A guide to your child’s heel pain

Dion Kapnias
by Dion Kapnias
Summer is here, sport is back and kids are back outside exercising and playing sport! Let all parents of young kids and teenagers rejoice!!!
Great news, right? 
Well yes, but there’s just one potential problem …. the realist in me acknowledges that it’s rapid increases in exercise and sport that can actually lead to more injuries amongst kids and teenagers. 
One of the more common injuries that we see as a result of this sudden increase in exercise, particularly amongst kids and teenagers, is heel pain caused by Severs Disease –  so let’s dive into a bit more detail.



What is Severs Disease? 

Severs disease is described as inflammation of the growth plate of the heel (the bone at the back of the foot). Similar to Osgood Schlatter’s Disease, it occurs as a result of repeated stress on the area. For example, lots of running, jumping or sprinting. This often happens at the start of a sports season, or when there’s a sudden spike in the exercise or sporting activity that your child is doing. Children aged 8-15 years are most likely to develop Severs Disease.

What are the signs and symptoms of Severs Disease? 

Your child will often describe the following:
·   Heel pain felt first thing in the morning
·   Increased pain with running and jumping
·   Tender to touch their heel
·   They may limp after an activity such as running or training
·   Tight calf muscle and Achilles tendon
·   It can often be felt in both feet (Approximately 60% of kids experience it in both heels!)

Why does Severs Disease happen? 

Severs occurs in growing children, often at the start of a growth spurt. During these periods, the growth plate can be more susceptible to injury. Combining this with an increase in sport or activity places your child at a higher risk of developing Severs, particularly if they’re involved in high impact activities like athletics, footy or basketball.
Severs is an example of when there is a disparity between what physical activity the bones and muscles can tolerate. For example, when sprinting, your calf muscles are anchored to, and pull on your heel bone, where symptoms of Severs are usually felt. Too much load on this area can pull on the growth plate and cause stress to it, leading to symptoms.

Will my child be more likely to have ongoing injuries and pains after having Severs Disease? 

No, Severs is a common childhood injury. If it’s appropriately managed, your child should be able to resume their normal activities with some minor adjustments. 
Essentially, don’t worry, Severs is certainly not a long term injury. Similar to its distant cousin Osgood Schlatter’s, it also doesn’t lead to a more severe injury. It is a common cause of heel pain in young kids, and will often resolve within 3-6 months.
However, it’s wise to get on top of this early through the help of an awesome physiotherapist. Getting treatment early really does help, and will help to minimize the time that your child is out of action. 

5 top tips to treat heel pain caused by Severs Disease.

Here are 5 great ways to help treat OSD –
1. Get some Heel lifts: Placing heel lifts in your shoes can help to cushion the heel and offload the achilles, leading to reduced inflammation and stress on the heel. You can get these from our clinic and various other places!

2. Use a Foam roller: Particularly to the calf! This will help to reduce feelings of tightness and relieve some of your child’s pain. See here an awesome demo of how to treat your heel pain using a foam roller.

3. Manage their exercise and sporting load: Much like our advice around Osgood Schlatter’s, try reducing your exercise and sporting activity by 25%.
For example, reduce the 4 training sessions your child does per week to 3 sessions per week.
This is crucial to allow recovery and healing. If your child is still struggling with symptoms, reduce their sport and exercise load further again by another 25%

4. Use Ice: Icing your heel can help to reduce inflammation, ease pain and enhance recovery

5. Step up Exercise: use this exercise where your child steps up a step whilst staying on their toes.  It helps to strengthen the calf muscles so that they’re better equipped to meet the demands of the sport. 
See video on how to perform a “plantarflexion step up” exercise to strengthen the calf muscles to help overcome heel pain from Severs Disease. 

All 5 of the above recommendations can be completed at home. However, if you’re struggling to settle your child’s heel pain down and you think it might be Severs, please book in to see one of our friendly physios and they’ll be able to get you on the pathway to recovery!!
Dion is a Physiotherapist working at Pathways Physiotherapy. To book in to see Dion, click here.