Hindmarsh call:

(08) 8359 2022

Book Now


Referrals & Faxes:

(08) 8312 3052


Call Now

Inertia Physiotherapy


Heel & Ankle Pain In Children - How can Physiotherapy and Podiatry Help?

Heel & Ankle Pain In Children - What is Severs Disease?

Common Names
Calcaneal Apophysitis | Sever’s Disease

What is Severs Disease?

Severs disease is a common condition which is characterised by pain around the heel bone and is usually found in active children. This pain is usually around the epiphyseal line or growth plate of the heel. The condition is known to be self limiting and pain is due to inflammation around attachment of the Achilles tendon. Once ossification of the Achilles tendon occurs pain in the region ceases (James, Williams, & Haines, 2013). Pain during walking is usually common, however, pain increases with running and jumping and particularly during sports such as football, soccer, basketball and gymnastics.

What is the Cause or Aetiology of Severs Disease?

Pain is usually caused by inflammation due to traction and repetitive strain of the Achilles tendon on the growth plate of the heel. Inflammation and pain can usually be caused by ;


  • Biomechanics of the foot and leg-pronating foot type or a high cavus foot type
  • Growth spurts - causing gastrocnemius and soleus tightness (calf muscles)
  • Muscle imbalances of the posterior hip and thigh - Trauma to the calcaneal apophysis area (heel)
  • Increased BMI

Who Does Severs Disease Effect – What is the Epidemiology ?

Posterior heel pain is found to account for 2%-16% of presentation to Physiotherapists & Podiatrists (James et al., 2013). The condition usually presents in children and adolescents between the ages of 8-15 years old but has been found in children as young as 6 years old (James et al., 2013). It is common for children to report a recent growth spurt.

What is Physiotherapy & Podiatry Treatment & Management of Severs Disease?

Physiotherapy and Podiatry Treatment of Severs disease depends on the stage of the disease and the symptoms at presentation. Physiotherapy & Podiatry treatment is aimed at educating the child and parents as to what is causing their pain and how to best manage it – when some pain is tolerable and when the pain is too much and requires rest. Keeping the inflammatory factors and pain down are important in managing these conditions as well as keeping the tissue tone down and load reduction on the heel.

  • Modified rest and/or cessation of sporting activities (decreasing duration / intensity/ frequency)
  • RICE
  • Complete immobilisation (offloading walker) if required
  • Heel lifts or cupsTaping
  • Modifying and/or changing footwear
  • Orthotic Therapy
  • Joint Mobilisations
  • Stretching / Foam Rolling and strengthening exercises
  • Night splints if required
  • NSAID’s (non- steroidal anti-inflammatory medication e.g Nurofen)
  • Steroid injection in severe cases
  • Surgical - if condition has been neglected it can result in a calcaneal avulsion fracture


Prognosis for this condition is usually very good when managed correctly – children are able to continue sporting endeavours with minimal pain and disability. Early intervention is important in assisting managing this condition. Prognosis is poor when this condition is managed poorly.

If you think your child is experiencing heel pain contact Inertia Health Group to book in an appointment 

James, A. M., Williams, C. M., & Haines, T. P. (2013). Effectiveness of interventions in reducing pain and maintaining physical activity in children and adolescents with calcaneal apophysitis (Sever’s disease): a systematic review. Journal of Foot and Ankle Research, 6(1), 16. doi:10.1186/1757-1146-6-16




Book Now