Parents often bring their children to our office because they have noticed their children walking funny or limping after playing. You may notice the limping occur after playing certain sports or prolonged periods of walking; you may consider it just growing pains and shrug off the initial presentation of it. However, I would like for you to reconsider whether your child is experiencing common “growing pains” or perhaps is suffering from an actual pathological problem called Sever’s Disease.
First and foremost, Sever’s Disease is not a disease; rather an inflammatory process that occurs in the heel also called “calcaneal apophysitis”. In other words, pain occurs in the back of the heel due to inflammation at the growth plate on the heel bone.
Why does pain occur in this particular area of the heel? The Achilles tendon is the main aggravating factor. It inserts on the back of the heel and constantly applies a pulling force to the heel bone where the growth plate is located. Because of excessive traction of the Achilles on the heel bone, the growth plate becomes inflamed. This inflammation can cause mild to moderate pain in the back of the heel extending to the bottom of the foot. It can also cause swelling and redness to the heel if left untreated.
Sever’s Disease affects children between the ages of 6-14 years old, which is usually the age group that children become more involved in sports. Baseball, football and soccer are the most common sports that cause heel pain in children. Cleats are notorious for causing Sever’s Disease and constantly re-aggravating heel pain that has gotten better.
So if you notice your child developing any of the symptoms discussed so far, talk to him or her about what is causing the pain and how often it is occurring. If your child is consistently experiencing pain with certain activities or shoes, then treatment should be started at home.
One of the first treatments that should be performed is also the most important…stretching. Achilles tendon stretches such as a runner’s stretch against the wall and performing toe touches, standing and sitting, should be performed at least twice daily (especially before and after practices or games). Exercises should be held in a sustained stretch for 5-10 seconds each. Stretching helps lengthen the Achilles tendon and decreases the amount of pull occurring at the heel bone which reduces pain. Applying ice to the heel after games can also help resolve the pain and should be applied 10-15 minutes at a time. Finally try resting the affected heel by decreasing your child’s activity level for 2-3 days to see if the pain resolves.
If you’ve attempted these treatments at home for one week without any reduction in pain, then you should consider having your child evaluated at Advanced Podiatry. Lingering heel pain does not get better without treatment, especially if your child is involved in PE at school or after-school athletics. Our doctors will perform a comprehensive exam to fully understand why your child is experiencing heel pain. X-rays (if needed), gait evaluation, and evaluation of shoes/cleats are also crucial in the treatment of heel pain in pediatric patients. The doctors at Advanced Podiatry will determine if your child would benefit from heel lifts or custom orthotics which can help reduce heel pain and provide more stability to athletic cleats.
Ultimately when the growth plate fuses completely, the pain will most likely resolve; however, the growth plate usually doesn’t fuse until around 15 years old, sometimes even later in boys. Sever’s Disease can become a chronic condition for your child and can cause complications later in life if not treated properly. So if you have noticed your child limping after activities or dealing with heel pain that won’t go away, call Advanced Podiatry (813)875-0555 and let the Doctors at Advanced Podiatry help alleviate your child’s heel pain today.
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