How we treat Severs - growing pain in the heel

Similar to Osgood Schlatters, Severs is a growing issue except Severs effects the heels not the knees

At Core Advantage, we have been fixing Severs disease for as long as we have been fixing Osgood Schlatters.

Whilst our Osgood Schlatters online rehabilitation program has exploded around the world with 1000’s of young athletes successfully eliminating their knee pain and returning to sport, we began putting our Severs solution into an online program for anyone to use.

We have been quickly fixing this serious and debilitating heel problem for well over a decade. Time and time again, we have defied conventional wisdom, and rapidly helped young athletes return to sport pain-free while still in the middle of a growth spurt.

Today I’m going to reveal how to eliminate the heel pain caused by Severs Disease in a matter of weeks.

Severs Disease case study: Jack

The catalyst for this article was soccer athlete Jack and his sore heels. Jack started with Core Advantage having carried Severs heel pain for more than 6 months.

A young athlete with Severs disease

Three weeks after starting with us, his Severs heel pain had gone from a 6/10 to a 1/10 on both legs, and he had returned to full training and playing levels for his soccer.

Now, after finishing the full seven week plan, he is a constant 0 out of 10 for pain, and moving around the field with more speed and power than he ever has before.

Jack is a 14 year old kid who has been sidelined by severe pain in his heels. Despite having a strong athletic frame and many years of sport under his belt, Jack was not a good mover. In fact, his mum said he is often one of the slowest in his team over short distances and struggles with agility based training drills.

Throughout the period of his heel pain, Jack had been receiving focused treatment from a diligent and excellent health practitioner. They were kind enough to send me a 2-page letter detailing all the adjustments, mobilisations, activations and rehab activities prescribed to Jack in an effort to alleviate his pain and get him moving again, all with no significant or lasting improvements.

After Jack completed his seven week program with us, I went back to the practitioners detailed letter. I was struck by the fact that despite being a textbook application of the traditional modalities for treating Severs Disease, the treatment list didn’t include ANY of our key methods. Not one!

To me, his medical plan was all frosting and no cake. Lots of messing around with small marginal gains but nothing striking at the true root cause of the problem when it comes to Severs Disease.

What is Severs Disease?

To understand our solution to Severs Disease, you first need to understand the problem. Put simply, Severs heel pain occurs when the shin bones (tibia and fibular) grows too fast for the calf muscles (Soleus and Gastrocnemius) to keep up. This means with every step the athlete takes the achilles tendon is pulling at its attachment on the heel bone (the calcaneus).

Severs disease at the achilles tendon
Here is an image of the calf and achilles tendon from the side. As you can see it connects directly on the back of the heel bone

Looking at this, it is pretty easy to understand that tight calves (and potentially muscles of the foot too) that can’t keep up with rapidly growing shin bones are going to cause drama at the heels. It’s as though the bones are literally ripping the tendon from its attachment on the calcaneus.

If that isn’t bad enough, this problem is compounded by the fact that the attachment site is not fully bonded in young bodies, as they need to stay soft to allow for further growth and skeletal maturation. With tall, active kids who have weak calves and glutes, heavy inefficient running styles, and long high volume sporting seasons, it’s not surprising that we see plenty of Severs and Osgood cases particularly in dancing, soccer, basketball, tennis, and netball.

So that’s the fundamental problem: Bones growing too fast for tight muscles resulting in still-developing attachment points becoming tender and sore.

How to treat Severs quickly?

Step one: Create length and flexibility in the calf

The first and most important thing to do when trying to fix Severs Disease is to create some length and flexibility in the calf to accommodate the rapid bone growth and take pressure off the attachment site of the achilles tendon into the heel.

However, the typical mistake we see is stretching the calf. The problem is that by performing a stretch of the calf, you are actually pulling on the sore attachment point and potentially making the pain worse. This is not a great approach especially for heels that are already sore!

This is where rolling for self myofascial release becomes essential for active young children. Rolling allows you to create length and improve flexibility in the calf and entire lower body without pulling directly on the sore tendons as you would with stretching.

Foam rolling for Severs disease
It is very important to do this slowly and release all the trigger points. Throughout the program we provide detailed video instructions on all the exercises you need to eliminate Severs Disease heel pain

Step two: Create strength in the calf

A lack of strength is often hidden as it can be hard to see weakness, especially in strong-looking bodies. This weakness often stems partially from muscles that become inhibited in the presence of pain. This localised inhibition is a reflex that comes in handy at preventing us from pushing an injured body part harder than it should, but they are also very problematic for athletes with growing pains, as this inhibition generally means that the muscles that should be absorbing the kinetic energy of movement are inactive, leaving the tendons and joints to take the majority of the forces we experience during sport.

For the purposes of rehabilitating Severs Disease, these are bad reflexes**.** The great news is we can reactivate these muscles and get the calves to do their job again with the right kind of exercises.

The benefits of calf isometrics

Isometric holds (or ‘Isos’) with the heel hovered just slightly off the ground are amazing at helping settle down pain in the heels while simultaneously activating and strengthening the muscles of the calf and foot - I frequently see a single dose of isometric holds take someone from 7/10 soreness to 0/10 in under 5 minutes.

Strength exercises for Severs disease
A standing isometric calf raise for the treatment of Severs Disease

How to solve growing pains in the heels

This is just part of our solution to eliminating heel growing pains caused by Severs Disease, and we commonly see athletes who follow this program return to playing sports, stronger and pain-free in 7-weeks or less.

Our online rehabilitation program for Severs Disease is supported by the latest in rehabilitation scientific evidence and developed by a certified sports scientist. The progressive training plan begins with the solutions mentioned above - foam roll to loosen the calves, and using isometrics to start strengthening your way out of the problem - before progressing an athlete to completely eliminate their heel pain.

The rest of the online program involves lower body strengthening and mobility exercises to build the strength needed to absorb ground reaction forces, and create a de-load needed for young tendons to adapt. The last piece of the puzzle is movement skill retraining, where we teach athletes to run, jump and change direction efficiently to reduce the cumulative stress on the heels and making faster, stronger, pain-free young athletes.

All of these components, and step-by-step instructions to complete the plan are included in our online 7-week Severs Disease Pain Elimination Program. You will receive a 7-week training plan, exercise logbook, instructional videos and photos, along with digital support from our certified sports scientist to help rapidly beat Severs Disease and return to sport pain-free.

Online Programs to relieve Osgood and Severs

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Osgood Schlatters treatment program

Get the Osgood Schlatters treatment program

A comprehensive seven week training plan to treat the cause of growing pain in the knees. Includes helpful resources,  professional support, and access to a supportive Facebook community.

$59.95 USD

Adult Osgood Schlatters program

Over 18 years of age and still struggling with Osgood? This program is designed specifically for you! A comprehensive seven week training plan to relieve your pain and get you back to a full and active life.

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A severs disease treatment training program

Get the Severs treatment program

A comprehensive seven week training plan to treat the cause of growing pain in the ankles and heels. Includes helpful resources,  professional support, and access to a supportive Facebook community.

$59.95 USD

A severs disease treatment training program

Cure heel pain forever by treating the root cause

  • Exercises suitable for athletes of all ages at home or in-gym
  • One payment for lifetime access to the program
  • Online program hub with all the resources you need

$59.95 USD