Sever's in Young Athletes
Sever’s is a common cause of heel pain in active children and young athletes. It often develops during periods of rapid growth, especially in children who do a lot of running, jumping and hopping. The free resource explains that increased tension through the calf muscles and repeated loading around the heel can irritate the area and lead to pain during sport.
For parents, coaches and young athletes, the key message is that heel pain should be taken seriously, but it can usually be managed well with the right balance of load reduction, strength work, recovery and a gradual return to sport. The free resource also makes clear that children can often stay involved in sport at an appropriate level, provided their pain stays under control.
What Is Sever's?
Sever’s is a common source of heel pain in growing children, particularly those who are active in sport. During growth spurts, the muscles and tissues around the lower leg can become tighter, which may increase strain around the heel. Repetitive impact from sport can then aggravate the area and lead to pain.
It is particularly common in children who take part in sports involving lots of running, sprinting, jumping or changes of direction. Rather than being caused by one single injury, it is more often linked to repeated load over time combined with growth-related changes in the body.
Who Gets Sever's?
Sever’s is most often seen in active, growing children. It can affect one heel or both, and is especially common during years when children are growing quickly.
Children who regularly play football, rugby, athletics, gymnastics, tennis, netball or other high-impact sports may be more likely to experience it. Factors such as tight calf muscles, reduced ankle flexibility and foot posture may also play a part.
What Are the Symptoms of Sever's?
The most common symptom is pain in the heel during or after sport. This may be worse when running, hopping, jumping or doing lots of impact-based activity.
Some children are comfortable when resting, but the pain returns as soon as activity levels rise again. The heel may feel tender when squeezed or pressed, and some children may start limping or changing how they run to avoid discomfort.
Why Does Sever's Happen?
Sever’s usually develops because the heel is being asked to cope with more load than it can currently tolerate. This often happens during growth spurts, when the body is changing quickly and muscles may feel tighter than usual. It can also appear after a sudden rise in activity, such as returning from a holiday, starting a new sports season, attending a training camp, and increasing weekly training or match play.
Other factors may increase the risk too, including poor recovery, low sleep, stress, poor nutrition and doing the same sport all year round without enough variation.
How Can You Reduce Pain From Sever's?
When the heel is painful, it is often helpful to temporarily reduce high-impact activity. This does not always mean stopping all sport completely, but it may mean cutting back on running, sprinting, hopping and jumping until symptoms calm down.
Some children benefit from a short reduction in impact-based sport, icing the heel after activity, calf massages, supportive footwear, and shock-absorbing heel pads. The main aim is to calm the irritation while keeping the child as active as reasonably possible.
Can a Child Still Play Sport With Sever's?
In many cases, yes. Children can often continue being active as long as the activity stays within a manageable pain level and does not significantly worsen symptoms afterwards or the next day.
A helpful rule is to use a simple pain scale out of 10. If pain stays low and settles quickly, activity may still be appropriate. If pain becomes more noticeable, lasts for longer after exercise or is worse the following day, the activity level may need to be reduced.
Where needed, lower-impact exercise such as swimming or cycling can help a child stay fit while the heel settles.
How to Return to Sport Safely
Returning to full sport should usually be gradual rather than immediate. A child may first need to rebuild tolerance to walking, jogging and light running before going back into full training, matches or competition.
A step-by-step return tends to work best: Begin with lower-intensity activity, increase running gradually, reintroduce changes of direction, return to training before competition, and build back up slowly rather than all at once.
This gives the heel time to adapt and reduces the chance of repeated flare-ups.
What to Do if the Pain Flares Up Again
Flare-ups are common and do not necessarily mean the child has gone backwards completely. In many cases, it simply means the heel has been given slightly more than it can currently tolerate.
If symptoms rise after activity or are worse the next day, it is usually sensible to reduce activity for a short period and then build back up more gradually. This is often more effective than either pushing through significant pain or stopping all movement for too long.
Why Strength Matters
Strength is an important part of recovery. When children have heel pain, they often become less active, which can lead to weakness elsewhere in the body.
Building strength through the calves, legs and trunk can help the body cope better with sport. This may also improve how well a child tolerates running and jumping when they return to activity.
Mobility and stretching can also help, especially during growth spurts when areas such as the calves, hamstrings and hips may feel tighter than usual.
Running Technique and Heel Load
In some children, the way they run may increase pressure through the heel. A heavy heel strike or overstriding pattern can sometimes add extra impact. Simple running cues may help reduce load, such as encouraging a child to run lightly, keep their stride controlled, and land with the foot more underneath the body rather than too far out in front. This is not always the main cause, but it can be one helpful part of an overall recovery plan.
How to Help Prevent Sever's From Coming Back
Reducing the risk of recurrence usually involves more than just waiting for the pain to settle. It helps to look at the bigger picture, including growth, training load, recovery and strength.
Useful prevention steps may include: Avoiding sudden spikes in training volume, building activity back up gradually, planning recovery days, improving lower limb strength, wearing supportive footwear, and monitoring sport during rapid growth periods.
Children who are growing quickly may need closer monitoring, as the body can become more sensitive to load during these phases.
Recovery, Sleep and Nutrition
Recovery matters just as much as exercise. Sleep, nutrition and rest days all play a major role in helping a child cope with sport and recover well from training.
Children who are not sleeping enough, skipping meals, under-fuelling or doing too much without enough recovery may be more likely to struggle with repeated pain.
A balanced diet, good hydration, regular meals and enough sleep can all support healthy growth, tissue recovery and return to sport.
When to Seek Professional Help
It is sensible to seek professional advice if heel pain is not improving, keeps coming back, affects sleep, causes limping, or stops a child from taking part in normal activity.
A qualified health professional can help assess what is driving the pain, advise on the right exercises, and guide a safe return to sport based on the child’s symptoms, sport and stage of growth.
Towards the end of our free resource, there is also useful advice around recovery, strength, pain management and gradual return to sport, which supports this same overall approach.
Frequently Asked Questions About Sever's
What is Sever's?
Sever’s is a common cause of heel pain in active, growing children. It is often linked to growth spurts and repeated impact from sports such as running and jumping.
What are the symptoms of Sever's?
Typical symptoms include heel pain during or after activity, tenderness around the heel, discomfort when running or hopping, and pain that improves with rest.
Can my child still play sport with Sever's?
Often, yes. Many children can stay active if pain remains manageable and does not worsen significantly after activity or the following day.
How long does Sever's take to settle?
It varies from child to child. Some improve quite quickly with reduced load and better recovery, while others need a longer period of gradual progression depending on growth, strength and sporting demands.
Does my child need an X-ray?
Not usually. Heel pain of this type is commonly diagnosed based on symptoms, age, activity levels and clinical assessment.
How can I help stop Sever's from coming back?
Gradual training progression, good recovery, enough sleep, supportive footwear, improved strength and careful monitoring during growth spurts can all help reduce the risk of recurrence.
Concerned About Your Child’s Heel Pain?
Reviewed by Kids Back 2 Sport
Based on educational material by Angela Jackson on Sever's and young athlete health.