Injury Articles

Sever’s Disease

By June 27, 2018 No Comments

What is Sever’s Disease?

Sever’s disease is a common cause of heel pain in young active individuals. It is more common in boys and can affect one or both heels. The pain results from where the Achilles tendon pulls on the heel.

What are the risk factors?

Risk factors include:

  • boys going through puberty.
  • high training load, particularly in flat footwear e.g. football boots.
  • changes in body height/weight e.g. growth spurt.
  • high body mass index (BMI).

Signs and symptoms

Signs and symptoms of Sever’s Disease include:

  • heel pain made worse with/after exercise, particularly running
  • limping after physical activity
  • Tiptoe walking

Diagnosis and treatment

Sever’s Disease can be diagnosed through clinical examination by a doctor or one of SportsCare and Physiotherapy’s qualified physios.


  • aims to relieve symptoms through education, exercise, and training load management
  • may include footwear advice/inserts.
  • typical treatment involves: ice, addressing biomechanical impairments, modifying provocative activities, using a heel raise, education for self-management

Training load management

Reducing or modifying training load is important to manage flare-up of Sever’s Disease. This includes:

  • modifying how often, how much, or how hard they are training.
  • consulting with a physiotherapist is useful to help identify a suitable training load baseline.
  • once the initial flare-up has settled down, it is important to make small increases in training load to avoid re-flare of symptoms.

An example of too high a training load for a 12 year old boy:

Summer weekly training

  • swimming training.
  • running total = 0 mins.

Winter weekly training

  • soccer 3 x training/game (180 mins)
  • AFL 2 x training/wk (240mins)
  • running total = 420 mins. (Large spike in training)


The training load can be modified by:

  • reducing the time of each training session
  • reducing the number of training sessions
  • monitoring how hard the individual is working
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