SEVERS DISEASE: Heel Pain in Children
2020 is gone and competitive sport is well and truly back! After the year we have endured the welcome return to sport was a blessing, however it has led to the increase in prevalence of a number of different patient presentations here at 13th Beach Health Services. With winter sports now well underway and therefore an increase in physical activity for most, we have seen a number of children presenting with heel pain. As a parent, you may notice that your child is limping while walking or running and they might complain of pain in the heel after training or games, as well as first thing in the morning. If this sounds like your child then it might be due to Severs Disease.
What is Severs Disease? Severs disease, also known as calcaneal apophysitis, is an irritation and inflammation of the growth plate in the heel. It is caused by repetitive stress on the area, which is more common following an increase in physical activity. Due to the lack of competitive sport in 2020 it is no surprise that for many there has been a big increase in load in the last 4-6 months. However we also see Severs disease causing heel pain in children who are less active.
But Why?? Severs disease is most common in 8-16 year olds and often occurs during growth spurts, when structures such as bones, muscles and tendons are rapidly changing, which along with increased activity load also places extra stress on the heel region. There are a number of other factors that can increase the risk of Severs disease including the presence of flattened arches of the feet and poorly fitting shoes, and therefore it can commonly occur in both of the heels.
The heel bone, or calcaneus, provides the attachment site for many different tendons and ligaments from the lower leg and foot, including the thickest tendon in the body, the Achilles tendon.
While we are growing and these bones and tendons are still developing, an increase in activity can cause more stress on these structures. Increasing physical activity which often increases movement through the foot and ankle can lead to the achilles tendon placing excessive traction upon the heel bone, leading to the body responding with inflammation of the area.
So how can the team at 13th Beach Health Services help?
Firstly we aim to provide some reduction in symptoms and therefore some relief from pain. We need to reduce inflammation and decrease or eliminate load. Icing with a frozen water bottle under the foot can assist with decreasing inflammation and can be used in combination with stretches and foam rolling as advised by our practitioners.
Our team of highly trained Osteopaths and Physiotherapists will complete an assessment of the foot and ankle, as well as a functional assessment of the knees, hips and joints of the lower back in order to gain a better understanding of how the body is transmitting load. This holistic assessment allows us to better understand the cause and address it to ensure symptoms don’t return.
Our practitioners will then use different techniques, such as soft tissue massage and movement of these joints to alleviate the tension placed on the calcaneus. We will also be able to provide a thorough and tailored rehabilitation program to get your kids back doing the sports they love.
Do we need to get orthotics?
If your practitioner thinks it is appropriate it might also be necessary to be reviewed by our in house Podiatrist – Catherine. She will take a look at your child’s footwear and may tape the foot, provide heel supports or suggest an orthotics if required.
Finally – Listen to your child! If your child complains of heel pain this isn’t normal. Suspect Severs until proven otherwise.
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At 13th Beach Health Services we pride ourselves on our multidisciplinary approach to every patient. By using a combination of our different practitioners we guarantee a thorough and tailored management plan for your child. If you have any other questions or concerns we suggest coming into the clinic to speak to one of the many practitioners here at 13th Beach Health Services who can help! Call the clinic today on 5254 2668 or book online.