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Date issued:  December 2022

For review: December 2024

Ref: C-330/Physiotherapy/LB/Severs Disease v3

PDF:   Severs disease final December 2019 v2.pdf [pdf] 383KB

What is Severs Disease?

Severs disease is pain in one or both heels when walking.  The pain comes from the area between the sections of bone that make up the heel.

As you go through a ‘growth spurt’ the tendon at the back of the heel (Achilles tendon) pulls at the heel bone.  This causes inflammation of the growth plate (an area of developing bone) in the heel.

The reason the tendon is tight is because your bones grow faster than your muscles.

It usually affects:

• Boys between 8 to 10 years old

• Girls between 10 and 12 years old

• Children in a ‘growth spurt’

• Children involved in sports, usually those that involve running and jumping.

How can Severs be managed?

There is nothing you can do to stop severs disease. It will stop when you finish       growing. However the following will help to      relieve the symptoms;

Rest

• Cut down on the time you spend playing sport until the pain has gone.

• Avoid sports that involve a lot of running or jumping.

• Swimming can be a useful alternative.

Ice

• Ice the affected area for 10 to 15 minutes, especially after activity.

• Make sure you protect the skin by wrapping the ice in a towel.

Elevation

• Elevate (raise) the leg when painful and swollen especially after sports.

Pain relief

• Pain relieving medication may reduce pain and swelling, but you need to  discuss options with a pharmacist or GP.

Always wear shoes

• Avoid activities in bare feet or wearing shoes with hard soles.

Physiotherapy Exercises

Gastrocnemius stretch: 

Place one leg in front of the other with both feet facing forward.  Bend your front leg and keep your back leg straight. 

Hold for 30 seconds, repeat 4x on each leg.

Soleus Stretch: 

Place one leg in front of the other with both feet facing forwards. Bend both knees and move weight forwards onto your toes.  Hold for 30 seconds, repeat 4x on each leg.

What causes Severs disease?

Sports involving running and jumping such as track, basketball, gymnastics, and soccer  increase the risk of Severs disease. Poor  fitting shoes, flat feet and leg length discrepancies also increase susceptibility to Severs disease.

Signs and symptoms;

• Swelling and redness of the heel

• Difficulty walking

• Stiffness of the feet upon waking

• Discomfort when both sides of the heel are squeezed at same time

• Walking on tiptoes or with a limp

Symptoms are usually worse during and immediately after activity and subside with rest.

Recovery

It may take several weeks or months for the pain to completely stop. In most cases    severs disease goes away on its own with a little rest and time.  If you ignore the pain and play through it, the condition may get worse.  When the pain is completely gone, you can slowly return to your previous    level of activity.

With future growth spurts the pain may return, therefore keep up with the stretches and follow the advice given.