By Nic Andrews, Assistant Physiotherapist: Woollahra Physiotherapy

Severs disease is a common cause of heel pain affecting mostly girls 8-10 and boys 10-12. The pain is caused by excessive forces and damage to the growth plate of the heel during the early adolescent years.

As a parent it’s important to notice if your child may be suffering from Severs Disease so they can be treated by a physiotherapist as soon as possible to prevent worsening symptoms.

Here’s what to look for:

- Limping

- Running awkwardly

- Increased heel pain when raised on tippy toes

- Pain may be felt in one or both heels

As physiotherapists it is our role to conduct in depth screening of foot and leg biomechanics as well performing a range of clinically diagnostic tests to identify Severs Disease. We assess the foot and leg for decreased ankle dorsiflexion, over-pronation / over-supination of the hind-foot, reduced calf length etc. All of which can be predisposing risk factors to Severs.

Once diagnosed, we will follow a 7 phase treatment process that aims to eliminate pain and restore normal function.

Phase 1: Early Injury Protection: Rest, ice and protect

Phase 2: Regain Full Range of Motion: Identify and correct stiff joints and tight muscles

Phase 3: Regain Foot Arch Muscle Control: Your Physiotherapist will assist you in maintaining dynamic stability in your foot.

Phase 4: Restore Normal Calf & Leg Muscle Control: Assess leg muscle function and provide necessary treatments or exercises.

Phase 5: Restore Normal Foot Biomechanics: Foot biomechanics are the main predisposing risk factor to Severs, after a biomechanical assessment your Physiotherapist may supple you with orthotics to correct your foot posture.

Phase 6: In order to prevent re-injury its important you correct your technique in these aspects.

Phase 7: Footwear analysis: Poorly designed shoes can contribute to your injury

To prevent Severs Disease it’s important to maintain good joint movement and muscle flexibility in those younger years.

Finally, it’s really important you listen to your child, if your child is suffering heel pain from the ages of 8-12 suspect Severs Disease until proven otherwise by a qualified Physiotherapist.