The Winter sports season is starting to ramp up with trials in full swing. Kids are also starting to run more than they may have done over the summer months, and we have started to see plenty of kids presenting with pain in their heels. Most commonly they are diagnosed with Sever’s Disease.
Sever’s disease (sounds terrible but it’s not so bad!) is a condition that affects children who are going through a growth spurt and who are physically active. As the bones in the leg grow, the muscles can sometimes have trouble keeping up and can start to pull where they attach into the bone causing inflammation and pain. The calf muscle in this case, where the Achilles attaches into the back of the heel.
Sever’s is most often found in girls aged 8-11 and boys aged 10-13, although we often see it in much younger kids.
Kids who play sports that have lots of running and jumping often suffer the most. Footy boots are notorious for increasing the symptoms as they often have a low profile (not a very high heel) and not much cushioning. So AFL players are prime candidates as well as netballers with all the running and jumping involved.
The good news is this can get better. Managing Sever’s can be difficult as you essentially need to help the calf muscle to lengthen but should avoid stretching it as it will increase the symptoms at the heel! Seeing a Physio can help guide this process as well as reduce pain and keep your child playing in the meantime.
Does your child have any of these symptoms?
- Pain at the back of their heel or around the Achilles tendon
- Heel pain during and after physical exercise, especially activities that require running or jumping
- Worsening of pain after exercise once cools down, often lasting until the next day
- A tender swelling or bulge on the heel that is sore to touch
- Calf muscle stiffness first thing in the morning
- Limping
- A tendency to walk on tiptoes (to minimise stretch on muscles and ‘pulling’ on the attachment site)
Symptoms your child may experience
- Pain at the back of their heel or around the Achilles tendon
- Heel pain during and after physical exercise, especially activities that require running or jumping
- Worsening of pain after exercise once cools down, often lasting until the next day
- A tender swelling or bulge on the heel that is sore to touch
- Calf muscle stiffness first thing in the morning
- Limping
- A tendency to walk on tiptoes (to minimise stretch on muscles and ‘pulling’ on the attachment site)
How can we help manage it?
It is often said that severs is self-limiting and will resolve over time when children finish growing. However, there are things you can do to help reduce the pain now:
1. Relative rest
Help your child decide what is more important i.e. running around at lunchtime or playing sport on the weekend? If your child can reduce their activity in one area that is least important to them this is likely to provide enough rest to allow the inflammation to settle. We can help you decide how much rest is required to help with the pain.
2. Ice/ cold packs
Using ice after activity will help settle down any inflammation and relieve pain. Apply for 15-20 minutes.
3. Biomechanical risk factors
A physiotherapist will be able to identify any factors that may be contributing to the condition i.e. tightness or weakness in surrounding muscles which is causing excessive load through the foot.
4. Footwear/ shoe inserts
Good supportive shoes + inserting a heel lift into their shoe will help take tension off the Achilles and reduce the pull that is exacerbating the inflammation.
5. Medication
Ask your GP if it is suitable for your child to take an anti-inflammatory to help settle the inflammation.
6. Time
Generally, the pain will ease in one to two weeks up to several months, although there may be flare-ups from time to time.
7. Massage
A physiotherapist can advise you on how to massage the calf to help reduce the tightness/ tension through the Achilles.
8. Avoid stretching when necessary
It is important to avoid stretching when they are in a lot of pain as this will increase the pull on the heel bone. When their pain settles stretching can be reintroduced as an important therapy to help prevent the onset of another inflammatory episode.
If you think your child may be suffering from this condition please book in to see us so that they don’t miss out on this season.
CLICK HERE TO BOOK ONLINE or call us 99683424
