As a sports chiropractor working closely with young athletes, one condition I frequently encounter — especially during baseball season — is Sever’s Disease. While the name may sound intimidating, Sever’s Disease (formally known as calcaneal apophysitis) is a relatively common and manageable condition among growing athletes.

What is Sever’s Disease?

Sever’s Disease is an overuse injury of the growth plate in the heel (the calcaneus). It typically affects young athletes between the ages of 8 and 14, especially during periods of rapid growth when the bones are maturing faster than the muscles and tendons can adapt.

In baseball athletes, repetitive running, sudden sprints, and constant cleat use on hard surfaces place significant stress on the Achilles tendon, which tugs on the immature heel bone, leading to pain, inflammation, and tenderness at the back of the heel.

Common symptoms include:

• Heel pain during or after activity
• Limping or walking on toes to avoid heel pressure
• Increased pain with squeezing of the heel
• Stiffness upon waking or after long periods of sitting

How to Manage Sever’s Disease

1. Activity Modification

Rest is helpful. Complete shutdown isn’t always necessary, but reducing high-impact activities like running and jumping can prevent further irritation. Cross-training with low-impact activities like swimming or cycling may help maintain conditioning without stressing the heel.

2. Footwear Adjustments

Baseball cleats often have minimal heel cushioning. Athletes should consider shoes with better arch support or adding cushioned heel cups or a brace (I like Tuli’s X brace). These braces absorb shock and reduce pressure on the growth plate during movement.

3. Stretching and Strengthening

Tightness in the calves, hamstrings, and plantar fascia can exacerbate symptoms. Implementing a targeted stretching program focused on these areas is key. Strengthening the foot intrinsic muscles and stabilizers of the ankle also supports proper biomechanics and reduces strain.

Chiropractic Treatment Considerations

As a sports chiropractor, my approach focuses on promoting healing while keeping the athlete functional whenever possible. Some effective treatment strategies include:

1. Cold Laser Therapy (Low-Level Laser Therapy)

Cold laser is a non-invasive treatment that uses specific wavelengths of light to reduce inflammation, promote tissue repair, and ease pain. In Sever’s Disease, applying cold laser therapy to the heel region can accelerate recovery, often reducing symptoms significantly within a few sessions.

2. Kinesiology Taping

Strategically applied kinesiology tape can help unload the Achilles tendon and provide mild compression to the inflamed area. Taping techniques can support the heel’s soft tissues, promote lymphatic drainage to reduce swelling, and encourage better biomechanics during movement.

3.  Manual Therapy and Adjustments

Gentle joint mobilizations of the foot and ankle can improve overall biomechanics and help address any compensations that might arise from altered gait patterns. Soft tissue therapy to release tight calf muscles and plantar fascia also plays an important role.

4.  Exercise Modification

As your sport chiropractor, one of my favorite things to do for young athletes is help make a plan that keeps them safely in the field of play.  Few treatment plans often include complete rest or abandonment of sport.  Writing a strengthening plan for your young athlete is one of my favorite things to do!  Let’s work together as a team to keep in the field of play, safely, and with minimal to no pain or discomfort. 

While Sever’s Disease is self-limiting (it will eventually resolve as the growth plate closes), early recognition and appropriate management can dramatically improve an athlete's comfort and minimize time away from sports.

As a sports chiropractor, my goal is to keep young athletes active, help them heal efficiently, and educate them and their families about prevention strategies to avoid future setbacks. If your young baseball player is complaining of persistent heel pain, don’t ignore it — early intervention can make all the difference.

If you have questions about Sever’s Disease or how chiropractic care can help your athlete, feel free to reach out. I’m always happy to help athletes perform and recover at their best!

This is the Tuli’s X Brace that I commonly recommend to patients: https://amzn.to/3GtGn1i