Sever’s Disease Explained: Spotting the Early Signs

At Willow Grove Physical Therapy, we often see children struggling with heel pain, a common issue that may be linked to Sever’s disease. This condition, though frequently overlooked, is a leading cause of heel discomfort in active kids, especially those involved in sports. It affects the heel’s growth plate, resulting in pain and discomfort, which can interfere with a child’s ability to enjoy physical activities. If you’ve noticed your child limping or hesitating to play, it might be time to consider Sever’s disease as a potential cause. In this blog, we’ll explore what Sever’s disease is, how physical therapy aids in treatment, and how you can help prevent it.

What is Sever’s Disease? 

Sever’s disease is an overuse injury that typically affects children between the ages of 6 and 14. It causes heel pain, often worsened from physical activities like running, jumping, or other sports. During growth spurts, when bones grow rapidly, muscles and tendons may struggle to keep up, placing additional stress on the heel’s growth plate. This imbalance results in the pain associated with Sever’s disease. 

Causes and Risk Factors of Sever’s Disease 

Sever’s disease is caused by repetitive stress on the growth plate of the heel, leading to inflammation and pain. Several factors increase the risk of developing this condition: 

Growth Spurts: During rapid growth phases, children’s bones grow faster than their muscles and tendons, putting extra strain on the heel, which increases the likelihood of pain and inflammation.  

Foot Arch Issues: Conditions like flat feet or high arches can affect the alignment and mechanics of walking, running, and jumping, which puts added stress on the heel. 

Increased Physical Activity: Overtraining or suddenly ramping up activity levels can lead to Sever’s disease, especially if the body doesn’t have enough time to adjust to higher intensity or frequency. 

Common Symptoms of Sever’s Disease 

• Heel Pain: The pain worsens after activities like running or jumping and may subside with rest. 
• Swelling: Some children may experience mild swelling around the heel. 
• Tenderness: Pain or sensitivity when pressure is applied to the heel. 
• Pain with Squeeze Test: A squeeze test often results in pain on the sides of the heel, confirming the condition. 
• Activity Limitation: Children may begin avoiding certain sports or activities due to discomfort. 

How is Sever’s Disease Diagnosed? 

Diagnosing Sever’s disease typically involves a physical exam and a review of the child’s medical history. A squeeze test, where gentle pressure is applied to both sides of the heel, often helps confirm the diagnosis. In rare cases, additional imaging may be needed to rule out other conditions. 

Important of Diagnosing Correctly 

Sever’s disease is often misdiagnosed as other heel conditions, leading to improper treatment and delayed recovery. The pain from Sever’s disease is similar to conditions like Achilles tendonitis or plantar fasciitis, so treatments targeting those conditions, like tendon stretches, won’t relieve the stress on the growth plate. Misdiagnosis may also result in children continuing high-impact activities, worsening the condition and increasing the risk of long-term complications. Recognizing the key symptoms—activity-related pain, heel tenderness, and swelling—helps ensure the right diagnosis and faster recovery, allowing young athletes to return to their sports safely. 

Treatment Options for Sever’s Disease 

While Sever’s disease often resolves on its own with time, physical therapy plays an essential role in treatment by reducing pain, restoring mobility, and preventing future episodes of heel pain. Here’s how: 

Stretching and Flexibility Exercises 

Physical therapists focus on improving the flexibility of the calf muscles, which connect to the Achilles tendon. Tight calf muscles contribute to the stress placed on the heel’s growth plate. Specific stretches, like calf wall stretches, help lengthen these muscles and alleviate pressure on the heel. 

Strengthening Exercises 

Strengthening the muscles in the lower leg, ankle, and foot is vital for reducing the strain on the heel. Exercises like eccentric heel raises help strengthen the calf and Achilles tendon, supporting better movement patterns and absorbing more impact during physical activities. 

Biomechanical Adjustments 

Some children may have structural issues like flat feet or high arches, which increase the risk of Sever’s disease. Physical therapists evaluate a child’s gait and foot alignment to identify contributing factors. In some cases, custom orthotics may be prescribed to correct alignment and relieve strain on the heel. 

Manual Therapy 

For children with tightness and discomfort, manual therapy, including soft tissue mobilization, can provide relief. These hands-on techniques help to improve circulation, reduce muscle tension, and promote healing, speeding up recovery. 

Slow Return to Activity 

Once pain and inflammation have subsided, physical therapists guide children back into physical activities in a controlled, gradual manner. A progressive plan ensures that children don’t rush back into sports too soon, which could cause a relapse of symptoms. Low-impact activities, like swimming or cycling, are often recommended to maintain fitness during recovery. 

Education and Prevention 

A crucial aspect of physical therapy is educating children and their parents on how to manage and prevent Sever’s disease. This includes teaching proper stretching techniques, the importance of appropriate footwear, and strategies for balancing activity levels. Understanding the signs of overuse and making adjustments can help prevent future occurrences. 

Preventing Sever’s Disease: Tips for Parents and Coaches 

While Sever’s disease can be managed effectively, prevention is always better. Here are a few key strategies to reduce your child’s risk: 

• Proper Footwear: Ensure that your child wears shoes with proper arch support and cushioning. 
• Moderate Activity Levels: Encourage balanced fitness routines that combine strength training, stretching, and rest. 
• Warm-up and Cool-down: Always include stretching before and after physical activities to avoid muscle tightness. 
• Strength and Flexibility Exercises: Focus on exercises that target the hamstrings, calves, and feet to maintain a balanced, strong body. 

How Willow Grove Physical Therapy Can Help 

At Willow Grove Physical Therapy, our experienced team of physical therapists is dedicated to helping children recover from Sever’s disease and prevent future injuries. We create personalized treatment plans that incorporate stretching and strengthening exercises best for you to restore function and mobility. Our goal is to help your child get back to their active lifestyle, free from the pain of Sever’s disease. 

If your child is experiencing heel pain or has been diagnosed with Sever’s disease, don’t wait. Schedule an appointment today and take the first step toward a full recovery.