SEVERS DISEASE – Symptoms, Signs and Treatments

Severs disease is the most common issue I have seen recently with children. The majority of them currently play football extensively!
It’s also called calcaneal apophysitis and its not really a disease, but an over use injury where by the growth plate in the heel can become inflamed and painful due to excessive force and of course repetition from over use..

What exactly is Severs disease?

The Achilles tendon attaches to the back of the heel by the growth plate. In children the heel bone will grow faster than it’s surrounding muscles, tendons and ligaments.

This in turn will cause tightness in the calf muscle which will reduce the ankles range of motion and put added stress through the achilles tendon especially where it attaches the heel bone or calcaneus. This will lead to pain for your child!



As your child stops growing and the surrounding soft tissue has a chance to catch up and adjust your child should grow out of it, providing the issue was managed properly in the first place.

What are the symptoms and what to watch for?

-Pain and tenderness at the back of the heel, this could be on both sides and may have a little swelling

-They may also complain of pain in the calfs to where the muscles have got tight!

-Pain will increase after physical activity particularly running and jumping. This can cause limping or cause your child to start walking on their toes

-If your child has had a recent growth spurt and is playing regular sport keep an eye out.

-You may find it improves with rest only to return when they start training again

-You child may complain of a little stiffness around the foot and ankle when they wake up in the morning.


What causes it?

-Playing sport on hard surfaces. At this time of the year training will go from grass to astroturf or indoors.

-Over training and over use of the body part will contribute, as I said in a recent article. But if your child is out playing the same sport most nights of the week this can take it’s toll!

-Poor footwear choices and a lack of cushioning for the heel. This is common with football boots, especially as in this day and age they are very minimalistic.

-An increase in physical activity especially running and jumping.

-Poor biomechanics can contribute to this condition


How can we help our kids?

-REST for Severs disease is key! Activity modification is very important, so removing non essential sessions, reducing frequency, intensity and ultimately the duration of the activity can help

-Do NOT let your child play through the pain. This can cause permanent damage to the bone.

-You can talk to your GP re NSAIDS and pain relief. BUT do not use pain relief as a way of getting your child to soldier on!!

-Get an assessment from a decent therapist who can assess and treat where appropriate. Sports massage from a professional on the calfs and surrounding soft tissue can help reduce tension. However direct massage over the painful area should not be done and can make it worse.

-Heel cushions can help decrease impact through the area.

The condition can last for months at a time and often return sometimes when you least expect it. Here are two videos you can use to self treat the calf muscle.

Foam rolling for the calf

My favourite calf stretch

For more info from Sports soft tissue therapist Rich Knight go to

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