Pre-season is here and summer is winding down. Kids and coaches are eager to train to get ready for the upcoming fall sports season. You may be shuttling your student to 2 soccer practices a day! Overtraining can cause injury such as heel pain in kids. As adults, we tend to get plantar fasciitis or plantar heel pain, but heel pain in adolescents is due to an irritation of the growth plate on the back of the heel. Sever's disease, also known as calcaneal apophysitis, is a common cause of heel pain in growing children, particularly those who are physically active. As a podiatrist, I frequently encounter concerned parents seeking answers and relief for their children. Understanding Sever's disease and its treatment options is crucial for managing this condition effectively.
What is Sever's Disease?
Sever's disease is an inflammation of the growth plate in the heel, typically affecting children between the ages of 8 and 15. This condition occurs during periods of rapid growth when bones, muscles, and tendons are developing at different rates. The repetitive stress and pressure on the heel from physical activities such as running, jumping, and sports can lead to inflammation and pain.
Symptoms of Sever's Disease
The primary symptom of Sever's disease is heel pain, which may be worse during or after physical activity. Other symptoms include:
Tenderness and Swelling: The back or bottom of the heel may be tender to the touch and swollen.
Limping: Children may limp or walk on their toes to avoid putting pressure on the heel.
Stiffness: There may be stiffness in the heel, especially after periods of rest or in the morning.
Causes and Risk Factors
Several factors contribute to the development of Sever's disease, including:
Rapid Growth: During growth spurts, the heel bone can grow faster than the surrounding muscles and tendons, leading to tightness and increased stress on the growth plate.
Physical Activity: High-impact activities, especially those involving running and jumping, can put additional strain on the heel.
Improper Footwear: Wearing shoes that do not provide adequate support can exacerbate the condition.
Flat or High Arches: Foot structure can also play a role, with children having flat feet or high arches being more susceptible.
Diagnosis
Diagnosing Sever's disease involves a thorough medical history and physical examination. The podiatrist may ask about the child's activity level, symptoms, and any recent growth spurts. In some cases, X-rays or other imaging studies may be ordered to rule out other conditions.
Treatment Options
While Sever's disease typically resolves on its own as the child matures and the growth plates close, several treatments can help manage symptoms and provide relief:
Rest and Activity Modification: Reducing or temporarily stopping activities that cause pain is crucial. Encourage your child to rest and avoid high-impact sports until symptoms improve.
Ice Therapy: Applying ice to the affected heel for 15-20 minutes several times a day can help reduce inflammation and pain.
Stretching and Strengthening Exercises: Specific exercises can help stretch the Achilles tendon and strengthen the calf muscles, reducing tension on the heel. A podiatrist or physical therapist can recommend appropriate exercises.
Proper Footwear: Ensure your child wears supportive shoes with good arch support and cushioning. Avoid flat, unsupportive footwear.
Orthotic Devices: Custom or over-the-counter orthotic inserts can provide additional support and reduce strain on the heel.
Pain Relief: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and reduce inflammation. Always consult a healthcare professional before giving medication to a child.
Shockwave Therapy: Extracorporeal Shockwave Therapy (ESWT) is a fast, effective treatment option that uses sound waves to stimulate healing and reduce pain in the affected heel. This non-invasive therapy can be particularly effective in promoting recovery and reducing inflammation.
Prevention
While Sever's disease cannot always be prevented, certain measures can reduce the risk:
Gradual Increase in Activity: Encourage gradual increases in activity levels to allow the body to adapt.
Proper Warm-Up and Cool-Down: Ensure your child warms up before and cools down after physical activity to prevent injury.
Supportive Footwear: Invest in high-quality, supportive shoes that are appropriate for your child's activities.
Sever's disease can be a painful and frustrating condition for active children and their parents. However, with proper understanding, timely diagnosis, and appropriate treatment, most children can find relief and continue to enjoy their favorite activities. Among the various treatment options, Extracorporeal Shockwave Therapy (ESWT) stands out as a fast and effective method for promoting recovery and reducing pain and inflammation in the heel. If your child is experiencing heel pain, schedule an appointment. We will develop an effective treatment plan tailored to their needs to get them back to sports pain-free.
If you have any concerns about Sever's disease or other foot-related issues, please don't hesitate to contact our office. Give us a call at 207-774-0028.
Early intervention and proper care are key to ensuring your child's foot health and overall well-being.