Severs - Knowledge Base

Find answers to the most commonly asked questions about the program and Severs Disease.

As part of the program we now have a private online community hosted through Facebook. To join, simply press the button below, answer the questions and you will be added to the group.

Answers For Your Questions

Find all the answers to the most commonly asked questions about the program and everything else Severs related on this page.

The most common mistake we see people make when trying to solve their Severs Disease is they rush. Skimming over the instructions, skipping ahead in the videos or ignoring key warnings.

If you have any concerns take the time to work through this webpage and the Google document to find your answer.

Questions & Answers

Completing the Severs and Osgood programs together

We wrote this Severs program off the back of incredible demand from those completing our Osgood Schlatters program.

This program is deliberately very similar in its structure and progression plan, with key adjustments and modifications to manage and strengthen the key areas specific to Severs and heel pain.

It is quite common for children to simultaneously suffer from growing pain in their knees and heels, or to go through periods of injury suffering from one diagnosis at a time. if this sounds like you or are interested in also building strong knees with our Osgood program you can do so.

Because the programs complement each other so well, you need not pay full price for the second training plan, use the coupon code DOUBLE at checkout and get 30% off the price of the second program so you can gain access to both plans.

Double program modifications

If you choose to complete both programs together we recommend you follow the Osgood program as your core plan and add on the calf specific activities as they come up. This means you will complete the knee and calf isometric holds as instructed and add calf raises and stride outs earlier than the Osgood plan instructs.

My question isn’t in the list below?

Below is a small list of the most commonly asked questions regarding Severs Disease and this program.

For more specific support (if you cannot find the answer here or in the Google doc) please join our Facebook support group.

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I still have bad heel pain, should I start this program?
Yes. The program is designed to help young, rapidly growing athletes beat their Severs Disease by mobilise and strengthen their way out of that pain so they can get back to playing the sport they love.

Please note however: This program is designed specifically for Severs Disease. You should not begin this program without a medical diagnosis of Severs Disease. While this program is 100% effective at curing Severs, it may not be as effective for other heel conditions.

I have already been doing some of the program from week one. Can I skip ahead?

The short answer is no. Even if you have been doing the foam rolling  we recommend you still complete the first two weeks of the program. The heel are really about laying a foundation for the work to come and hustling through that phase has the potential to compromise the entire program.

Do I have to join a gym?

Not necessarily. While having a leg extension machine certainly helps, similar results can be achieved with grocery bags or ankle weights at home. We will show and detail options for both gym access and home training throughout the program.

What do I do if my condition is not Severs Disease?

Working online, we are not in a position to diagnose your condition. We recommend you seek a medical opinion as to the cause of your pain and confirm (with a doctor, physio or physical therapist) that it is indeed Severs Disease.

Other heel conditions may respond negatively to this program so a correct diagnosis is crucial. If you have been diagnosed with Severs and the program is making your heels worse, please get in touch so we can help you trouble shoot. My contact details are below.

What is the best foam roller?

Foam rollers can be bought from all sports and in some department stores. Our favourite is the Trigger Point 13″ original roller which you can get online from Amazon and most sporting good stores.

When in doubt aim for a roller that is at least 30cm long (12″), 12-18cm in diameter (5-7″) and softer is better for young tight athletes starting out.

The key factor when buying a roller is it should not have spikes as these create unnecessary pain with no added benefit (in fact, spikey rollers are mostly worse because they do not provide the even pressure needed to release out an entire muscle).

If you have not rolled before it is going to be painful to begin with but it’s important that you persist as this pain is due to the same tightness that is contributing to your heel pain. Over time the rolling pain will gradually decrease with regular rolling and should be gone within the first week or so. If your pain levels persist, don’t stress, your legs might be extra tight, or your roller is too firm. Try a softer roller and pay close attention to the details of the rolling routine.

Can I still play sport or do my regular activities?

Firstly, can you still do weight training?
We recommend you avoid performing other lower body strength training exercises (squats, lunges, etc) as they can interfere with the recovery process during this program. Instead focus on the seven week progression laid out on the website.
Feel free to continue with upper body and core training if you have already been doing this regularly.

Secondly sports training, competition, and recreational activities
* Please note: this applies to any sport/activity you regularly participate in. It’s not advised to start (or restart) new sports or activities while doing this program.

Depending on the severity of your case, most athletes find they can maintain most if not all of their regular training and playing throughout this program. We recommend that where possible athletes reduce their training load by 10-30% for the first two weeks to allow the mobilisation and strengthening work to have its full effect.

From weeks three onwards, a gradual return to pre-injury playing and training loads should cause no new problems for most athletes.

If however, any of the following occurs, we recommend reducing your playing frequency volume and intensity until the pain settles again.

  • Your parents or coach spot a noticeable limp or favouring of the sore heel when running.
  • Pain levels go above 5/10 during a training session or game
  • Pain the morning following a training session or game is greater than a 5/10

If unsure, we advise erring on the side of caution and doing slightly less than you think. especially in the first 2-3 weeks.

I’ve had my Severs for years, will this still work?

Absolutely. The sooner you start this program after being diagnosed the quicker your heels will respond. In longer-term cases of Severs (1+ year of continual symptoms), it can take a little longer to fully beat Severs Disease but this program will still work, however a little more patience and a slower progression rate may be required.

What if this doesn’t work for me?

We have never seen this program fail when done in its entirety with 100% adherence. If your heels are slow to respond then you may have to repeat each week before progressing. When done in its entirety this program has never failed. It may also be worthwhile seeking a second opinion as many other pathologies and chronic injuries of the heel can present with similar symptoms but require different rehabilitation protocols.

What do I do if my clinician doesn’t think I should do this program?

You should listen to your clinician, if having assessed you in person and investigated and read this program they still don’t think it is for you it may be best to listen. Getting a second opinion may be a good option in this circumstance.

Should I be using ice during this program?

Most people find they do not need to ice during this program. Ice can help by reducing pain but has little effect on curing Severs.

Should I be using direct heat application during this program?

Definitely not. Heat increases the inflammatory response, something we do not need more of in treating and eliminating your Severs Disease

Should I be using anti-inflammatories (NSAIDs) during this program?

Probably not. Like ice, they will not benefit the healing process. Only take NSAIDs if prescribed by a medical practitioner

Should I be using painkillers during this program?

Definitely not. Like ice they will not benefit the healing process. Painkillers also mask your pain levels making it impossible to accurately gauge how effective the training program is.

Do heel straps help?

In our experience heel straps (the kind that apply pressure onto the tendon under the heelcap) can provide some level of pain relief (whether this is due to placebo or not we aren’t sure). If you already use them and feel they help continue using them but if you don’t we would not recommend buying them.

Should I start/stop wearing orthotics or change my shoes?

Probably not. In our experience we haven’t seen much of a change created when making adjustments to footwear or inserts/orthotics. Every person is unique so they may work for you, but it definitely isn’t a big rock for this program to be successful.

I found some other exercises for Severs, should I do those as well?

No. This program works brilliantly for Severs as is. There is no need to add extra exercises or components to the routine. In fact, adding other components can actually have a negative effect on this programs results.

The rolling is incredibly painful, do we still have to do it?

Yes. The first two weeks of the program with the foam rolling and the calf isometrics are crucial to both the short term pain reduction and long term success of the program. I do assure you that the foam rolling will improve and even become enjoyable, but you just have to fight through the first few sessions as your very tight muscles become accustom to the roller. Starting with a softer roller can be one way of getting around this hurdle. As a bonus softer rollers are usually cheaper too.
NOTE: Rolling should never cause shooting or sharp pains and should never hurt your joints. If this occurs please stop immediately and seek medical advice.

I just finished week seven and my heels still hurt, what do I do know?

The first thing to clarify is how much they hurt. Go back through your workbook and look at all the pain numbers, have they been trending down? staying flat? or up and down?

If they have been trending down but are not yet at a zero, this is completely normal, in fact it’s still a success!

Your heels might just need a little more time to fully recover. Continue to follow the program from week seven and continue doing the week seven daily routine and workouts. Everyone adapts at a different rate, so be thorough and consistent with the training. It might also pay to do a further deload in your sporting loads for the second time through the program, giving your heels more time to rest and recover.

If your pain has not gotten better at all there are two potential answers.

  1. Go back to week one and start the program again, this time paying close attention to every single detail. This program has never failed to eliminate Severs pain when done in it’s entirety. It might also pay to do a further deload in your sporting loads for the second time through the program, giving your heels more time to rest and recover.
  2. It may be worthwhile seeking a second medical opinion as many other pathologies and chronic injuries of the heel can present with similar symptoms to Severs but could require different rehabilitation protocols.