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Heel Pain in Young Athletes – Epidemic or Over-Training?

Heel Pain in Young Athletes – Epidemic or Over-Training?


Last year, 30% of my son’s football team missed games because of heel pain & Sever’s.

There are already complaints of heel pain on this year’s team.

I am now on a mission of


Sever’s Disease (Heel pain in children)

What is Sever’s Disease?

Sever’s Disease (Calcaneal Aphophysitis) is not a disease, but a repetitious strain injury common in children between the ages of 8 and 14 years old.

It is a common cause of heel pain, particularly in the very active child. Patients with Sever’s disease complain of pain in the bottom surface region of the back of the heel. This is where the growth plate is located, and is not fully developed or calcified in a child’s foot.


Sever’s Disease is a repetitive strain injury caused by the following:
1.  High impact injury activities and sport like football, soccer, basketball, running, jumping and tennis
2.  Tight calf, hamstring & gluteal muscles
3.  Poor mechanics, structure and function of the foot, i.e. lack of hip stability
4.  Excessive pronation
5.  Rapid growth spurt

The above causes tension, inflammation and pain where the Achilles tendon inserts onto the calcaneus (Back/bottom surface of the heel bone).


1.  Pain and redness in the bottom surface and at the back of the heel
2.  Extreme pain when the child places their heel on the ground
3.  The pain is aggravated when running or jumping on hard or unstable surfaces
4.  The pain is reduced when the child walks or runs on their toes



Because part of the cause is tight muscles in the posterior chain (calf, hamstring, gluteal), prevention happens through flexibility and mobility in these muscles.  Unfortunately, youth athletes (young boys especially) aren’t known for hamstring flexibility so consistency with stretching is key.

Please hold off on the static stretching until AFTER practice.  This will help retain more flexibility and increase performance during practice.  For a great article on when do static stretch READ MORE HERE

Hip Stability

A strong core and good single leg balance ensure the gluteal muscles are doing their part for hip stability.  Without hip stability, the functional responsibilities of running, cutting and balance fall strictly to the lower leg and feet and those muscle become overworked.


Rest is a main component in injury prevention.  Rest allows the body to heal and recover from all the wear and tear of youth athletics.  If your child is in year-round high impact activities, you should consider taking a season off or a season of low impact activities such as swimming or yoga.

Kids need quality sleep as well.  Make sure your young athlete is getting enough sleep at night in a dark and noise-free environment


Proper warm up/cool down for the heel area before and after activity

Heat & Massage Therapy/Roller for the calves, hamstrings and gluteal muscles on a daily basis

Stretching exercises done gently and daily (see below)



lying pigeonLying Hip Stretch:

Begin with the bottom leg’s foot on the floor and work up to grasping and pulling the leg towards the chest.  Hold for at least 30 seconds

Active Release – Add small movements like ankle rolls, shifting the legs side-to-side while holding the legs up and going slowly in & out of the stretch.  Engage the core to protect the back.


single hamstringLying Hamstring Stretch with Wall:

Leg up the wall may bend at the knee but try and keep the bottom leg at the floor.  Hold for at least 30 seconds

If single leg is too intense, place both legs up the wall or bend the bottom leg to put the foot on the floor.

Active Release – Add controlled movements like ankle rolls and bend/extend the leg(s).  Engage the core to protect the back.

down dog tightDownward Dog:

Most important is to keep the spine as straight as possible and point sit bones towards the sky.  Hold for at least 30 seconds

If the stretch is too intense or form is compromised, modify by placing hands on a higher surface like stairs or solid chair against a wall.

Active Release – Gently raise and lower the heels, bend and straighten the knees, pedal the feet side-to-side or move slowly from push up plank to downward dog.

  • To target the hamstrings, let the heels raise while working the legs straight
  • To target the calves, let the knees bend while working the heels to the floor