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What is Sever’s disease?

Sever's disease or calcaneal apophysitis, is a condition characterised by pain in one or both heels which is caused by repetitive damage and inflammation of growth plates of the heel bone (calcaneus). Sever’s disease commonly occurs in children aged between 10 and 14. The heel bone is weaker in children than in adults, but the forces being applied to it by growth and sport are great. This makes the heel bone more prone to injury in young active children.

Mobility exercises to improve ankle function and stabilityAbove: Mobility exercises to improve ankle function and stability

Cause of severs disease

Sever’s diease is thought to be caused by a mismatch in growth of the calf bone to the calf muscle and Achilles tendon (tendon which joins the calf muscle to the heel bone). It is thought that the calf bone grows faster than the calf muscle and achilles tendon and so this soft tissue becomes uncomfortably tight. This places more stress on the immature heel bone which causes inflammation and pain. Also an altered foot position, such as a pronated foot (turned inwards) means that there is an uneven weight bearing on the heel bone which can contribute to Sever’s disease.

Diagnosis of Sever’s disease

A physiotherapist or a GP can diagnosis Sever’s disease by assessing your childs current symptoms and doing a thorough physical examination. An x-ray may be necessary to exclude other causes of heel pain, such as heel fractures.

What are the symptoms of severs disease

The symptoms of Sever’s disease include the following:
  • Pain in one or both heels or around the lower part of the back of the leg (the Achilles tendon)
  • Pain that is made worse during physical exercise, especially running or jumping
  • A tender swelling or bulge on the heel that is sore to touch
  • Stiffness in the calf muscle first thing in the morning.
  • A tendency to tiptoe.

Physiotherapy for severs disease

Physiotherapy can help manage the symptoms of Sever’s disease so that your child can continue to enjoy physical activity.

At, we provide specialised treatment for Sever’s disease. Physiotherapy treatment at will enhance your childs recovery and get them back to physical activity as soon as possible. Physiotherapy will be centred on:
  • Relieving pain
  • Reducing swelling
  • Relieving muscle tension and stiffness especially in the calf muscle
  • Reducing stress on the achilles tendon and calf muscle
An initial assessment with one of the physiotherapists at will determine if your child has Sever’s disease and following treatment may include:
  • Use of ice and ultrasound to reduce swelling and pain
  • Muscle stretching to lengthen tight muscles
  • Strapping or tape during activity to limit the ankle joint range of motion
  • Advice on pacing exercise while your injury is healing
  • Re-positioning the foot often using a heel raise to place less stress on the achilles tendon
  • Advice on an ankle foot orthosis to prevent over pronation of the foot during activity
At, we work alongside podiatrists who will provide your child with orthotics if necessary.

For more information to see if your child would benefit from physiotherapy or to book an appointment please call 0330 088 7800, or book online today!

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