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Sever’s Disease: heel pain in children

Calcaneal-Apophysitis- heel pain in growing children

If you notice your child limping or changing their style of running, ask if their foot hurts. Your child may be suffering from a common condition called Sever’s Disease that affects growing adolescents.
Children are participating in sports and competing at higher levels at younger ages, therefore, the incidence of Sever’s disease continues to rise. Common symptoms of Sever’s Disease include heel pain with limping, especially after running, difficulty walking, discomfort or stiffness in the feet upon awaking and or swelling and redness in the heel.
Sever’s disease is the most common cause of foot pain in young, active children. Children who play basketball, soccer, baseball or gymnastics are commonly affected. Sometimes the initial symptoms are so mild that they can go unnoticed for weeks,especially if your child does not complain.
Sever’s disease often occurs in boys ages 9-15 and girls ages 8-13. Sever’s disease has a gradual onset and is typically triggered by a sudden and large growth spurt. During the growth spurt, the heel bone grows faster than the muscles in the calf and the Achilles tendon have the ability to lengthen. Therefore, the calf muscles and tendon become tighter. The pulling on the heel bone causes irritation that leads to an inflammatory response and Sever’s disease. Common symptoms are heel pain while walking or playing sports and tenderness along the back of the heel.
Sever’s disease is typically diagnosed based on information collected verbally and through a thorough examination by The Podiatrist.
Activities that require a lot of running and jumping increase forces through the heel bone and typically cause increase pain for children with Sever’s disease. Running and jumping on hard surfaces or in cleats may increase irritation levels. Standing on hard surfaces in cleats or participating in sports with poorly fitted or worn shoes also cause more severe symptoms. For example, a child that stands on the sidelines for extended periods of time during rugby or soccer games may complain of pain. It is important to protect children’s feet with proper fitting athletic shoes that should be replaced when the padding or heel starts to wear down.
Another risk factor for Sever’s disease is the position of the child’s foot when they walk or run. Pronation is a normal position of the foot that occurs when weight is transferred when walking and running. Excessive pronation can be a factor because it creates abnormal forces through the heel, which can lead to increase tightness of the Achilles tendon and create higher strain to the heel bone. Excessive pronation can occur when the arch of a child’s foot is excessively flat or high.
Childhood obesity is another risk factor for Sever’s disease because the excessive weight puts increased pressure on the heel bone. Sever’s disease rarely occurs in older adolescents because the growth plate of the heel bone stops growing around the age of 15. When the heel bone growth plate hardens, the bone becomes stronger which decreases a child’s risk for Sever’s disease.
The best way to treat Sever’s disease is to calm down the inflammation and correct the cause. Children must rest from the activity or sport causing the pain. They should not resume the activity causing pain until it can be performed pain-free. Other treatments include icing the painful area one to two times a day, gentle stretching of the muscles in the calf, and wearing properly fitted sneakers or shoes.
If your child complains of heel pain without a specific traumatic event try rest, ice, stretches and new shoes. The length of time for healing depends on the severity of the inflammation and treatment. If the pain persists, schedule an appointment with The Podiatrist. The Podiatrist will do an assessment to rule out other issues such as soft tissue tightness and trunk and leg weakness that can contribute to prolonged symptoms or recurrence of Sever’s disease.
If you feel you child may be suffering from Sever’s disease, book an appointment today
http://www.thepodiatrist.co.nz
http://www.kidsnmotion.co.nz

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