Sever’s disease is caused by overuse and excessive running and jumping, especially between the ages of 8–13. Factors that can cause Sever’s disease to become worse are:​

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• Sports with running or jumping on hard surfaces
• Standing too long
• Inappropriate footwear, such as shoes without enough support
• Overuse or too much exercising during growth spurts
• Inadequate warm up and cool down stretching

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Common symptoms related to Sever’s disease are:

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• Pain at the back of the heel
• Pain that radiates to the sides and bottom of the foot
• Limping, especially during running or jumping
• Difficulty walking
• Swelling or redness in the heel
• Preference for soft shoes and reluctance to walk barefoot

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To determine if your child has Sever’s disease, our specialists will perform a physical exam that may include flexibility tests, stress tests, muscle tests and gait analysis. These additional tests will help our specialized team better understand your child’s condition, assess range of motion and identify abnormalities that might occur in bone alignment or muscle function.

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After a physical exam, our specialists may also order imaging tests such as an X-ray.

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Possible non-surgical treatments your doctor may offer or recommend to treat your child’s Sever’s disease include:

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• Rest and activity modifications
• Physical therapy and home exercise program
• Over the counter nonsteroidal anti-inflammatory drug (NSAIDs)
• Heel cups may be used to ease the discomfort while walking
• Walking cast can be prescribed for severe cases to reduce the stress at the heel

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At-Home Care

Common at-home treatment options for Sever’s disease include:

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• Icing the Area: Put ice packs wrapped in a towel or thin cloth on your child’s foot for 20–30 minutes every 3-4 hours for the first 2-3 days. If pain does not go away, contact your healthcare provider.

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• Elevating the Injured Foot: Elevate your child’s foot by placing it on a pillow when your child is lying down. Elevating it above the heart level can help reduce swelling and pain.

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• Taking Non-Prescription Medication: Take a non-steroidal, anti-inflammatory drug (NSAID), such as ibuprofen as recommended by your healthcare provider.

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• Exercising: Your doctor may recommend doing exercises at home. These are designed to stretch the affected foot, maintain range of motion in the joint and strengthen your child’s foot.

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• While your child is growing, have them perform exercises that stretch the foot and ankle.
• Make sure your child does proper warm up and cool down stretches when exercising.
• Make sure all your child’s shoes have good cushion and support.

Below are common exercises a doctor may recommend to help your child recover after Sever’s disease. Always check with your doctor to find out which exercises are right for your child.

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Stretching

Towel Stretch

• Sit on a hard surface with injured leg stretched out in front.
• Loop a towel around the ball of the foot.
• Pull the towel toward the body keeping knee straight.
• Hold for 30 seconds. Repeat 3 times.

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Standing Calf Stretch

• Facing a wall, put hands against the wall at about eye level.
• Keep the uninjured leg forward and the injured leg back about 12-18 inches.
• Keep the injured leg straight and the heel on the floor.
• Keep toes pointed towards the wall.
• Next, do a slight lunge by bending the knee of the forward leg. Tell your child to lean into the wall until they feel a stretch in the calf muscle.
• Hold for 30-60 seconds. Repeat 3 times.

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Standing Soleus Stretch

• Facing a wall, put hands against the wall at about eye level.
• Keep the uninjured leg forward and the injured leg back about 4-6 inches behind the uninjured leg.
• Tell your child to keep both heels on the ground and gently bend their knees until they feel a stretch in the calf muscle.
• Hold for 30-60 seconds. Repeat 3 times.

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Range of Motion

Ankle Range of Motion

• Tell your child to pretend they are writing each of the letters of the alphabet with their foot.
• Move ankle in all directions.
• Do this exercise sitting or lying down.
• Ask child to draw pictures of animals, like a cat or a giraffe, if they don’t yet know the alphabet.
• Do twice.

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Strengthening

Single Heel Raises

• Hold onto a table and balance on injured side.
• Lift heel off the ground.
• Repeat 10 times, twice a day.
• Perform without holding onto anything for a greater challenge.

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Double Heel Raises

• While standing, balance on both feet behind a chair.
• Rise up on toes, hold for 5 seconds, then lower back down.
• Repeat 10 times. Do 3 sets of 10.

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Lunges

• Stand with the left foot behind right foot.
• Slightly bend the right leg to make a 90-degree angle with the right knee.
• Keep back straight and bend the left leg to lower to the ground.
• Feel a stretch in the left groin.
• Hold for 5 seconds, and switch legs. Repeat 10 times.

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