Is your child experiencing heel pain?

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Your podiatrist or health professional may diagnose your child’s heel pain as Sever’s disease.

What is Sever’s disease?

Sever’s disease is a common cause of heel pain in children and young adolescents. It typically occurs in highly active children between 8-12 years of age who are involved in sports that include running and jumping type movements (The Royal Children’s Hospital, 2011). 

In children of this age, the growth plate at the back of the heel, also known as the calcaneal apophysis, is yet to ossify. Sever’s disease is therefore believed to develop in response to the increased tension of the Achilles tendon following a growth spurt which causes irritation of its attachment at the posterior heel (Smith and Varacallo, 2019). 

How does it present?

Sever’s presents as pain at the back of the heel, often following physical activity. It can be present in one or both feet and is more common in boys. It typically coincides with an increase in growth and/or starting a new sport (Smith and Varacallo, 2019).

Following rest, the pain should subside and is not commonly present when the child wakes in the morning. In more severe cases, you may notice your child limping. The pain does subside over time but can present in a seasonal nature in particular sports. It is diagnosed clinically from the present symptoms and does not usually require imaging. 

What treatments can you try at home?

To treat this pain at home, you could try replacing or modifying footwear choices. Supportive exercise shoes are often found to be most comfortable for children with Sever’s and avoiding time barefoot when the feet are sore is a good idea. Ice packs can be used before and after physical activity to reduce the window of discomfort as well as gentle stretching or massage of the calf muscles twice daily. 

How can we as Podiatrist’s help?

Podiatrist can assist in the treatment of Sever’s disease by addressing factors that may predispose your child to suffering from heel pain (e.g. foot type). We can also offer footwear advice for specific sports as well as in-shoe modifications as required. Customised orthotics are also useful in reducing discomfort, bettering foot posture and can help prevent recurrence of this often frustrating pain. Modifying activity is also a useful tool to help manage symptoms. 

Our aim is to work with kids to keep them active and playing the sports they love. So if you feel your child may be suffering from Sever’s disease and are looking for assistance in managing their pain, book an appointment with us today! 

Sources

Smith, J.M. and Varacallo, M. (2019). Sever’s Disease. [online] Nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK441928/ [Accessed 16 Aug. 2019].

The Royal Children’s Hospital (2011). Sever’s disease. [online] Available at: https://www.rch.org.au/uploadedFiles/Main/Content/rheumatology/SEVERS%20DISEASE%20VPON%20-%20PDF.pdf [Accessed 16 Aug. 2019].