Sever’s Disease Stretches: Treating a Child with Heel Pain

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Sever's Disease Stretches - Sever's Disease Treatment

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Do you have a child with heel pain? This post covers Sever’s Disease stretches and Sever’s Disease treatment. Cure heel pain with the right stretches for Severs Disease.

What is Sever’s Disease?

Sever’s Disease, also known as calcaneal apophysitis, is inflammation of the heel. More specifically, it’s inflammation of the growth plate of the heel. It occurs in growing children, and presents itself as heel pain in kids that ranges from mild to severe.

Not every growing child experiences Sever’s Disease. It’s most common in children who are very active. Have an active child experiencing a growth spurt? His/her chances of Sever’s Disease increases.

Your doctor probably shared that the only Sever’s Disease treatment is ice and rest. While this is partly true, there are numerous other things you can do to help decrease your child’s pain and get him/her back to playing. This is where I should mention that I am not a doctor. I can only share the Sever’s Disease treatment plan that worked for my son, who was desperate to get back on the pitch.

Our Sever’s Disease Experience

My son was diagnosed with Sever’s Disease at age 13. He played on two soccer teams in the Spring season, and often complained of intermittent heel pain. It wasn’t consistent, so we chalked it up to sore feet. By the end of the Spring season he was often limping after games and crying from the pain. A trip to the orthopedist confirmed Sever’s Disease with a possible heel fracture. Due to his age, the growth plates in his feet were not even close to closing.

Growth plates are areas of growing tissue, near the ends of bones. Over time, they harden. But because they are the last portion of a child’s bone to harden, they are at risk for injury and fractures.

Our orthopedist’s Sever’s Disease treatment plan consisted of ice, rest, and physical therapy.

A trip to the physical therapist indicated that our son had extremely tight hamstrings. This was a result of growing two inches in less than four months. We also discovered that he has flat feet and over pronates. This causes stress on his leg muscles.

Flat feet, over pronating, fast growth, tight hamstrings, and above normal physical activity led to a child with heel pain and a Sever’s Disease diagnosis.

So what did we do to get him back on the pitch?

Sever’s Disease Treatment Plan

1. R.I.C.E

Rest, ice, compression, and elevation. It’s important to start there.

Rest as much as possible. Ice after exercise, and any time there is pain. Compression: as in socks, bandages, or tape helps during any activity. Elevate the heel when resting, and after activity.

In the comments section below you’ll see that reader Crystal also had good luck with using Kt Tape. This sports tape can be used in a variety of ways for many different types of injuries.

2. Sever’s Disease Stretches

I am amazed at what a regular stretching routine has done for our son. If you are not able to get to physical therapy, there are numerous stretches you can find online that will help. Stretches should be held for 20-30 seconds and should be repeated two to three times on each side. Your child should also do them two to three times a day.

Stretches that have helped:

  • Soleus Stretch Standing
  • Gastroc Stretch Standing
  • Seated Hamstring Stretch

The above stretches work the hamstrings and calves, which helps with Sever’s Disease. However, I would also encourage stretching all the leg muscles. This is something we discovered later, when the heel pain subsided and was quickly replaced by knee pain. Therefore, include quad stretches and IT band (iliotibial band) stretches as well.

There are some cases in which stretching might not be right for your child. For example, if your child does not have tight muscles. That’s why it’s best to see a physical therapist when you can.

3. Muscle Strengthening

Most young, youth athletes have not built up a lot of muscle. Strengthening the core and leg muscles can go a long way towards avoiding injury. Youth athletes do not need to lift weights to build muscle. They can use their own body weight.

Upon seeing a second physical therapist, when our son’s knee pain started, we learned that our son presented with tight hamstrings but was actually hypermobile. Hypermobility was causing his body to tense, and tighten up, to hold all of his loose joints together. When relaxed, he was actually quite flexible. We were told that the stretches above did not harm him. However, what he really needed was a good core strengthening routine as well.

Exercises that have helped:

  • Side Lying Hip Abduction (straight leg and bent knee)
  • Side Lying Clam Exercise
  • Straight Leg Raise
  • Pelvic Bridges
  • Squats
  • Heel Raises and Heel Deeps
  • Hip Hinge

4. Orthotics, Insoles, and Heel Cups

Athletes are extremely hard on their feet, and cleats offer little to no support. If you can, have your child’s foot examined to see if he/she could benefit from orthotics. If not, consider a heel cup or an insole with some lift in the heel. Raising the heel up slightly, in a child with Sever’s Disease, helps to take some of the pressure off of the heel.

Products that have helped:

The NxtMile insoles (pictured below) helped my son tremendously, before he was able to get custom orthotics. We ordered a pair of soccer ones, but they ended up being too narrow for his slightly wide feet. The football style worked perfectly for us, as they are a bit wider. These particular insoles have an elevated heel, which helps to take pressure off of the heel. The owner of the company was responsive and extremely helpful.

Tread Labs is another great company, that makes orthotics in varying sizes and arch support. If you do not want to shell out money for a custom orthotic, these are the way to go. Both my boys custom orthotics are too bulky for their cleats. They wear Tread Lab orthotics in their cleats without issue.

Superfeet is another insole brand. We’ve used them in the past, however as my boys are growing; we are finding they are too narrow in the heel for them.

5. The Right Shoes

You cannot underestimate how helpful the right pair of shoes are. If there is one thing that had a dramatic impact on my son’s pain, it was his cleats. As I mentioned above, cleats offer very little support. Constant running involves constant drilling of the cleats into the bottom of the heel. Inserts or orthotics can help. However, what really helped was switching over to turf shoes. Turf shoes have numerous small nubs as opposed to fewer/larger cleats. Some styles also offer more support.

Turf shoes that helped:

Puma King Turf and Adidas Mundial Turf

Both of the above turf shoes offer tremendous arch support. While they are not colorful and flashy, like the latest cleat styles, your kids feet will thank you.

Sever’s Disease Stretches + Treatment Conclusion

A short period of rest, icing, and a regular stretching/strengthening routine (in addition to turf shoes and orthotics) got my son back to playing at 60% within 2-3 weeks. By the Fall season (a total of 6-8 weeks) he was near 100%.

Unfortunately, we caught his Sever’s Disease late. If you are able to catch it early, your child with heel pain may heal much more quickly. Hopefully, the above Sever’s Disease Stretches and Sever’s Disease treatment suggestions will help.

Update: It has been a year since my son was diagnosed with Sever’s Disease. While we were worried that the symptoms would return, I am happy to report that my son has been pain free. He continues to do his Sever’s Disease stretches, wears orthotics, and continues to wear turf shoes for soccer. He grew another four inches this past year. Therefore, I am amazed that he’s been able to play without heel pain. I truly believe that the combination of stretching and strengthening, use of orthotics, and wearing good supportive shoes has helped dramatically.

Have additional Sever’s Disease Treatment tips that I didn’t mention above? Share them in the comments section below.

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2 Comments

  1. My 10 year old son was just diagnosed with Severs. He plays soccer relentlessly. It’s his passion. Two weeks ago, he played several soccer games in one weekend after just wrapping up basketball season as well as futsal season. To say my son plays hard is an understatement. He wears out cleats long before he outgrows them. Anyway, after the last game of the weekend, he suddenly complained of heel pain and was limping after the game. At first I thought it was nothing, then when the limping continued the next day, I scheduled an appointment with a podiatrist (one that used to work closely with my older daughter who played soccer and ran cross country all the way through high school). I suspected it was Severs and that is exactly what he was diagnosed with. Told us bc we brought him in so early that he could just try orthodic inserts into his cleats and tennis shoes and RICE after soccer games and practices. We did what he said for a week, but the pain got a little worse so I started looking up Severs to educate myself on exactly what it was and what I could try in order to bring my son some relief. I just wanted to say a tremendous thank you for your detailed and specific advice regarding Severs and soccer. I went out the very next day and bought my son a pair of the Adidas Mundial turf shoes and I have to say I was super super impressed. Not sure why the podiatrist did not suggest this. He simply said to put the inserts into his cleats (which does help). But using the inserts AND switching to turf shoes is BRILLIANT. He practiced in them tonight and said he ran with no pain. He also said when he took them off, his foot only hurt a little. So clearly, getting him a more supportive shoe had immediate payback.

    I plan to take him back to the doctor next week to discuss PT. I hate to start too many stretches yet bc I’m afraid (after reading a lot about stretching) that it is possible that stretching this early in the recovery process might actually do more harm than good. I do think stretching is critical. I just want to make sure he’s doing the right stretches the right way for what will help him the most. For sure we will be adding stretching at some point though. And will continue it long term.

    One other thing we did that seemed to bring quick relief for my son was taping the heel. I searched Severs heel taping and found several videos. I ultimately decided on a technique using KT tape. We put it on him this morning before we left for a day that would involve a ton of walking. To his surprise, walking did not hurt in his tennis shoes (with the orthodics) when his foot was taped. So in addition to all of your great recommendations, I recommend KT taping.

    1. Crystal – thank for taking the time to comment and share your success story! I am so happy to hear that you caught your son’s Sever’s Disease early, that he is doing well, and that you found this post helpful.

      You are absolutely right about the stretching. Make sure you see a physical therapist who can determine what your son’s issues are. Each child is unique in their build and what they need. Our first physical therapist said that our son had tight hamstrings. Our second physical therapist said that he was actually hyermobile and only presented as tight due to his body contracting and trying to hold all of his loose joints together. He said that the stretching wasn’t harmful, but that what he really needed was strength training. At 13 he was quite tall for his age and didn’t have the muscle to move all that mass. He’s nearing 15 now and doing well with his strength routine.

      I’m so glad you discovered Kt Tape. Thanks for the recommendation! We have a case of it in our house. We didn’t use it for the Sever’s Disease, though I know it has helped many with it. It’s great to have on hand for those active kids and all of their aches, pains, and injuries.

      Thanks again for taking the time to share your story. It means a lot that this post was able to help. I hope your son is able to heal quickly and fully enjoy the upcoming soccer season!

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