Sever’s disease is heel pain that can be really, really painful. Kids with severe cases of Sever’s may not be able to put their heels on the ground. It’s particularly common in active kids, between the ages of 8-14 years (puberty). Every child is different, and so is the severity of pain. The pain can last anywhere from a couple of weeks to months depending on severity.
We saw a rise in Sever’s disease last year within the clinic when lockdown ended. The cause of Sever’s is technically “unknown”, but we can make some educated guesses as to why this happened…
With sport season upon us, heel pain in kids peaks. It’s common in the return of sports that we see little humans limping off the field and out of the school gate with foot or heel pain. So what is heel pain and why does it happen?
Sever’s disease refers to inflammation of the growth plate in the heel, or our calcaneus bone. As muscles are growing and being used, sometimes this tension can pull onto the bone and cause irritation.
As your child grows, sometimes the bones grow quicker than the muscles attaching to them can keep up. In this case, the tibia and the fibula (long bones in the lower leg) grow quicker than the calf muscle and the Achille’s tendon. The Achille’s tendon attaches in and under the heel bone (Calcaneus) and the pulling and rubbing of the tendon with the quick growth leads to inflammation and pain. The calf muscle and Achille’s tendon are now “short” relative to the bones, meaning they are really, really tight!
And the same goes vise versa. When the bone is growing has the potential to further tension the muscles. This tension can be exaggerated when the foot mechanics aren’t moving in their full capacity. This has a domino effect and doesn’t allow the muscles to move out of a shortened range.
It is common in any young adult as they are growing, but sports and high impact activity such as jumping and running can aggravate it.
Time can vary between the first onset of symptoms to a full resolution. This can be from days, to weeks to months which is hard when our little human is in pain. This time frame is so broad as the inflammation in the heel bone can continue up until that growth plate and bone matures.
Well, we all basically had two years off activity and sport now, including the kids from their sports. Last year, the return to a “normal” life after lockdown saw our kids return to full on sports, without a nice gradual lead up. When we go from nothing so suddenly playing 2 or 3 sports, plus training schedules, it can be a shock to the system. Add in a growth spurt and it’s no wonder there’s a few aches and pains.
Well we don’t have to wait for that bone to mature for there to be relief. By reducing the tension in the muscles that attach onto the heel bone, we can start to decrease the tension through the heel. Our practitioners use ultrasound therapy to assist with managing inflammation, but we also look further away from the foot. Tension is never local to one part of the body, it can have a domino effect up the leg and also from other places coming down to the foot. By unwinding and working through these tension patterns with hands on and personalised exercises to go home with, we can reduce the load going though the heel bone.
The team at Boroondara Osteo are trained to not only treat the symptoms of Sever’s, but to look more broadly at the rest of the body, like the knees, hips and low back. We look for further postural restrictions that impact the calf tightness. Don’t underestimate how the pulling forces of other muscles higher up in the body can impact the lower legs and feet.
Whilst there may be no complaints of pain now, a quick 5 minute stretch routine wouldn’t go astray, including some calf stretching and some quad stretching at a minimum to counteract some of the stressors our little athletes may encounter as we once again return to a more normal routine
Might be worth getting on the front foot (haha no apologies for that one) and getting it checked out before it progresses.
The heel is an important part of our anatomy, it is a large landmark with lots of structures attaching. Sever’s is not the only thing we consider when looking at heel pain. It is common for other heel conditions to present similar in clinic.
Our diagnosis in clinic is made after a thorough history to understand why your body is moving the way it is and a clinical examination from our experienced osteopaths. Sometimes these conditions can come hand in hand with each other when there is some restriction through the body. This can especially come into play if there is any aches and pain in the knees or legs. Our osteopaths look at the big picture to create a management in the short term, but also to look beyond at why and prevention.
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