Severs Disease

Severs disease is a common cause of heel pain in children and young people.
The condition causes pain and discomfort at the heel where the tendon of the muscle attaches to the bone. There may even be a swelling on the heel that is painful to touch.

Severs disease occurs because the bone is growing at a faster rate than the tendon and muscle. Thus the muscles in the back of the calf (the gastrocnemius and soleus) become tight. Symptoms are often made worse if the child has had a recent growth spurt.
Pain is usually felt during or after sport, but in severe cases, pain may be felt just walking around.

Symptoms may continue for several months.

Normally, Severs disease occurs in children aged 8-16 years.
Generally, it is young people who are very sporty or active who develop the condition. Boys are affected more commonly than girls.

Young people with Severs disease may have had a recent growth spurt.

Apply an ice pack, such as a bag of frozen peas wrapped in a damp cloth, over the painful area for 10 minutes, twice every day. Be careful, ice can burn, especially in bony areas or where circulation is poor.

Please seek advice about pain relief medication from your child’s GP or a pharmacist.

Limit sport strictly to within comfort; this means your child stopping an activity before they feel pain or reducing the time spent playing sport if they feel pain after stopping.

For any sport your child is managing to participate in, they should wear trainers with good shock absorbency. Gel shock absorbers can be bought from sports shops, chemists or supermarkets to place in the heels of their school shoes or trainers for extra comfort.

If your child continues to complain of pain during or after activity, or cannot limit themselves, then a complete break from all sport (including running around) is needed. The aim of treatment initially is to allow the inflammation to reduce.

Once the inflammation has reduced it is very important to stretch out the two tight muscles in the calf (see below). This will prevent pain from returning as soon as the activity is increased again

1 Gastrocnemius stretch

Standing, with one leg in front of the other with the affected leg behind, your child should lean against a wall allowing their front knee to bend forward. The leg behind should remain straight with the heel on the floor and toes pointing forward. A gentle stretch should then be felt in the calf of the back leg. This position needs to be held for 30 seconds, then repeated three times.

2 Soleus stretch

Your child should begin in the same position, but instead of leaning forward, they should simply bend both knees, again feeling a gentle stretch in the calf muscle of the back leg. The stretch needs to be held for 30 seconds and repeated three times.

Reduce the stretch if the muscle is sore.

If symptoms affect both legs, repeat exercises on each leg, three times a day.
It is vital that your child does not stretch too hard, as this will increase their pain, and aggravate the condition.

Stretching will take a few weeks to make any significant improvement. After this time, your child should notice that they can do more activity without pain. It can take a few months before your child is back to full activity levels without pain.

Even once your child is pain free, it is good for them to carry out the stretching exercises before and after sport. All of the treatment advice recommended in this leaflet should be restarted if the symptoms return – this is most likely after a growth spurt.

This condition will go away once your child has stopped growing.

If you are unhappy with any aspect of your child’s physiotherapy care, please contact:

Team Leader Children’s Physiotherapy Ipswich Hospital Heath Road Ipswich IP4 5PD Tel: 01473 702185

We aim to offer an excellent physiotherapy service to you and your child. We welcome your comments and suggestions.