Severs Disease – A Sore Heel That’s A Pain For Your Child

Published: 20 Sep 2021

Severs Disease – A Sore Heel That’s A Pain For Your Child

Heel pain is a common complaint among adolescent children.  We all want our kids to be active and healthy – but what do you do when keeping them active seems to be causing heel pain? Today we will be exploring a common cause of heel pain in the growing adolescent and child.

What is it?

Pain in the back of the heel where the Achilles tendon joins the bone. 

Why and how does this happen?

The calf muscle joins the back of the heel onto a growth area through the Achilles tendon. This growth area is softer than mature bone and is susceptible to injury and irritation. Activities that include repetitive calf contraction such as jumping and running may contribute to the onset of this condition.

What sports are these seen in?

  • Basketball
  • Soccer
  • Track 
  • Cross country
  • Gymnastics
severs disease kids footy physiotherapy

Keeping kids active through the tween and teen years is great for physical and mental health.

Factors which may be associated with the onset of Severs Disease:

  • Recent growth spurt 
  • Children aged 8-15 years 
  • Excessive and/or intensive physical activity 
    • Repetitive activities such as jumping, running and sprinting 
  • Recent increase in loads (more frequent or longer training sessions)
  • Prolonged periods of barefoot or thong walking
  • Recent height or weight gain
  • Tight calf muscles
  • Poor footwear
  • Physical activity on harder surfaces
  • Calf tightness 

Sever’s usually affects active kids who are involved in sports with explosive movements such as sprinting, jumping, and kicking (hello soccer, footy, netball, basketball, running….you get the picture). One heel is usually affected, but in some cases both heels can be affected.

Signs and symptoms of Severs include:

  • Insidious onset of pain
  • Tender to touch the bottom of the Achilles tendon 
  • Pain during running, kicking or jumping
  • Pain is worse after exercise
  • Swelling of the Achilles tendon
  • Stiffness in the calf muscle
  • Limping (in moderate to severe cases)
  • Can affect one or both heels 


Strategies for managing heel pain in Sever’s may include:

  • Rest and activity modification 
  • Ice: after exercise when discomfort is at it’s worse
  • Appropriate footwear: you can’t go wrong with good cushioning and a well fitting shoe
  • Shoe inserts: heel lifts or heel cups can help reduce the load on the Achilles tendon
  • Stretching the calf
  • Foam roll the calf 
  • Taping 

It is not necessary to ride this one out.  Keeping kids active is really important. See one of our Physiotherapist for a speedy recovery and good management.