Patient Story

I wanted to share the story of a patient I’ve seen recently, a 10-year-old boy who plays football. He’d been playing in two under-11 football teams for the past two seasons. Recently, he transitioned to a more competitive team, where training sessions increased in frequency and intensity. What had once been a few weekly sessions quickly turned into nearly daily practice, along with weekend matches. This is something we hear often, someone who shows promise, having their training commitments really ramping up!

Over the spring, his parents noticed that he began to limp slightly after matches. He often complained of pain in his right heel and ankle, especially after training on hard surfaces or following prolonged running. However, the discomfort was inconsistent, sometimes resolving by the next day, so his parents assumed it was likely to be just typical “growing pains.” They encouraged him to rest when needed but because he loves playing football, allowed him to continue training and playing (you’ll understand this if you’ve ever had to try and keep a football mad youngster away from the game!).

Trigger for Seeking Help

The turning point came when the patients coach noticed him sitting out more frequently during training and he was becoming more reluctant to sprint or kick with full force. Concerned, the coach recommended that he was checked out to see what was going on. That’s when his parents chose to book an appointment at goPhysio for an assessment.

Assessment and Diagnosis

During that first appointment, the patient described a sharp, aching pain at the back of his right heel that he felt got worse when he was active, particularly after running, jumping, or training on harder ground. When he was assessed, the Therapist found a really localised tenderness on the calcaneus (heel bone), and a positive ‘squeeze test’ confirmed heel pain under pressure. Analysis of his walking pattern showed a mild limp, and a thorough biomechanical assessment highlighted tight calf muscles and early fatigue in his calf muscle group.

Given his age, activity level, stage of growth and what was revealed during his assessment, he was diagnosed with Sever’s disease (calcaneal apophysitis). This is a common injury, where there is ‘overuse’ at the growth plate in the heel area. It’s often seen in active children, typically in boys aged between 9–12. The condition happens when the heel’s growth plate becomes inflamed due to repeated stress and tension from tight or overused calf muscles pulling on the heel bone during periods of rapid growth.

Recovery Plan

Our team at goPhysio implemented a comprehensive treatment plan to manage his symptoms and support a safe return to sport:

Step 1: Activity Modification
The patient was advised to temporarily stop all high-impact activities such as running, jumping, and football drills for 3–4 weeks. This allowed inflammation to subside and protected the irritated growth plate from further stress. Non-weight-bearing activities such as swimming or gentle cycling were encouraged to maintain cardiovascular fitness.

Step 2: Stretching and Strengthening Program
A tailored home exercise plan was introduced to address muscle imbalances and reduce heel stress:

• Calf stretches (gastrocnemius and soleus) to relieve tension on the Achilles tendon.
• Achilles tendon loading using isometric holds and light resistance.
• Foot intrinsic strengthening to improve arch support.
• Hamstring and quadriceps strengthening to enhance overall leg control and reduce compensatory strain on the lower limb.
• These exercises were gradually progressed over the treatment period under supervision.

Step 3: Footwear and Orthotic Support
The patient’s every day and sports shoes were evaluated. He was fitted with well-cushioned, supportive footwear appropriate for both grass and hard surfaces. Soft heel cups were also provided to help absorb shock and relieve pressure from the growth plate during walking and return-to-play activities.

Step 4: Education and Prevention
One of the most important elements of his recovery was education. His parents and coach received guidance on:

Recognising early signs of overuse injuries.

• The importance of adequate rest and recovery — especially during growth spurts.
• Implementing dynamic warm-ups and cool-down routines.
• Long-term strategies for load management, such as alternating training surfaces and avoiding back-to-back matches when possible.

Outcome

He responded very well to the treatment plan. Within three weeks, his symptoms had significantly improved. By week six, he was completely pain-free and had resumed light, low-impact training such as ball handling, short jogs, and controlled drills whilst continuing rehab for his injury get him stronger and playing back in matches ready for next season.

At week eight, he returned to full participation in team training — now better conditioned, stronger, and more in tune with his body’s limits. His parents reported that he was more confident, showed greater focus on recovery routines, and felt empowered to speak up when something didn’t feel right.

Importantly, the patient avoided long-term damage or reinjury by taking time to heal properly, and by implementing new habits that will support his performance and wellbeing as he continues to grow and compete.

Key Takeaways

• Sever’s disease is common in young athletes during periods of rapid growth and increased training load.
• Early recognition and intervention are crucial to prevent chronic issues or long-term complications.
• A combination of rest, rehabilitation, footwear support, and education form the cornerstone of successful treatment.
• Building a culture of listening to young athletes — and respecting their physical and emotional readiness — is vital for healthy sport participation.

This patient was seen by Sophie, one of our Graduate Sports & Rehabilitation Therapists. Sophie has completed specific post graduate training, with Specialist Consultant physio Angela Jackson, from Kids Back to Sport. Kids aren’t mini adults, so the approach is very specialist, and Sophie uses her knowledge and skills to make sure your young person gets the right information & support.

If your young person has an ongoing football injury, why not take advantage of our special summer offer – A focused package designed specifically for teens and young athletes over the summer holidays. It helps address unresolved injuries, persistent niggles, and performance-limiting issues before the busy school sports calendar kicks off again in September. Saving over 10%. Get in touch to book now, limited spaces available.