Dealing With Severs Disease

Overview

Unlike adults, heel pain is very uncommon in children. When children do experience heel pain, it is highly likely to be caused by a disturbance to the growth plate in the backof the heel bone (calcaneus), where the Achilles tendon attaches to the heel. This disturbance is known as Sever?s disease or calcaneal apophysitis (inflammation of the growth plate). Sever?s disease is most common between the ages of 10 and 14 years, and it is one of several different ?osteochondroses? that may occur in other parts of the body, such as at the knee, such as Osgood-Schlatters Disease. This condition occurs in children because they are still growing and their bodies harbor many ?growth plates?. A growth plate, also called an epiphyseal plate, is an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the growth plates expand and unite, which is how bones grow.

Causes

Apart from age, other factors that may contribute to developing Sever?s disease include physical activity, any form of exercise that is weight bearing through the legs or stresses the soft tissue can exacerbate the pain of the disease. External factors, for example, running on hard surfaces or wearing inappropriate shoes during sport. Overuse injury, very active children may repeatedly but subtly injure the bones, muscles and tendons of their feet and ankles. In time, the accumulated injuries cause symptoms.

Symptoms

As a parent, you may notice your child limping while walking or running awkwardly. If you ask them to rise onto their tip toes, their heel pain usually increases. Heel pain can be felt in one or both heels in Sever's disease.

Diagnosis

Children or adolescents who are experiencing pain and discomfort in their feet should be evaluated by a physician. In some cases, no imaging tests are needed to diagnose Sever?s disease. A podiatrist or other healthcare professional may choose to order an x-ray or imaging study, however, to ensure that there is no other cause for the pain, such as a fracture. Sever?s disease will not show any findings on an x-ray because it affects cartilage.

Non Surgical Treatment

Occasionally, an orthotic may need to be prescribed for temporary or long-term correction of their foot biomechanics (eg flat feet or high arches). During the acute phase of Sever's disease a small heel rise or shock-absorbing heel cup placed under the heel pad of your child's foot may help to ease the symptoms. Your podiatrist or physiotherapist can assess your child's arch and guide you in the best management of your child's condition. We recommend that your child should never go barefooted during the painful stages of Sever's disease.

Prevention

The best way to prevent Sever?s disease is for your child to stay flexible and stretch the hamstring, calf muscles, and the Achilles tendon before and after activity each day. It?s important to hold the stretches for 20 seconds and stretch both legs, even if there is only pain in one. If he or she only has smaller symptoms, like swelling and some tenderness, consider your child lucky. They may only have to sit out for one to two weeks during the season. The best treatment is to immediately stop the activity that caused the pain. Elevate and ice the heel for 20 minutes at a time to relieve discomfort and swelling.

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