As kids are growing they may complain of aches and pains. Occasional discomforts that aren’t long lasting, don’t affect sleep and don’t affect regular activity may be typical. When a child complains more consistently, is limping, is avoiding activities they enjoy then it is time to see their family doctor and Physiotherapist.
It is important to remember that children are not simply “little adults”. Their growing bodies provide different challenges and issues, especially when highly active.
More kids here in Oakville are specializing early in sports. This means that they often don’t have an “off season”. They may play soccer through the spring and summer outdoors, only to continue on in an indoor season. They may play hockey all fall and winter and then continue and play 3-on-3 to maintain skills in the summer, as well as additional strength and conditioning or private coaching.
At our Oakville Physio clinic we see many children and adolescents with growth and sports related pain. A common area we treat in the 8-15 year old age group is heel pain. Some differentials are plantar fasciitis and achilles tendinitis. Sever’s disease is also a common source of pain in an active child.
What is Sever’s Disease?
A term that includes “disease” can be a frightening prospect for a parent to hear. Sever’s is also known as calcaneal apophysitis. It is caused when the growth plate of the heel bone is injured by excessive forces prior to maturity. The area this occurs is the back of the heel where the achilles tendon attaches. There may be some swelling, redness and pain to the touch in this area.
It usually occurs during growth spurts in adolescence. As a parent, you may notice the child / adolescent limping or changing their gait pattern with walking or running.
It is important to note that Sever’s can occur in children who may not be as active. This is because structure and biomechanics also play a factor. The Chiropodist or Physio will do an assessment that may include seeing how the child / adolescent stands, balances, moves, walks, and runs. They will assess the ankle and foot flexibility and strength. They will also likely assess the strength of the legs and hips.
The main factors that are though to lead to Severe’s include:
- Tight calf muscles.
- Decrease ankle flexibility (primarily dorsiflexion or toe to nose motion)
- Excess motion of the hindfoot (over pronation / flat foot, or supination / high arch)
- More time doing dynamic activities (running, dancing, jumping)
What is the Chiropodist and Physiotherapist Role?
As with any patient. Our Chiropodist (foot specialist) and Physiotherapists provide a complete assessment and begin treatment in the first session. Treatment for Sever’s is largely individual in nature and depends on the person and how they are presenting.
Treatment may include stretching, mobility work, strengthening around the foot, ankle, hips etc. It may also include icing or heating instructions depending on how inflamed the area is or how tight. The Chiropodist and Physio may also tape the area to offload and educate on appropriate footwear for sport and leisure. They may also suggest the child see a Registered Massage Therapist to work on tight muscles and tendons.
The treatment plan will help progress the child / adolescent back to activities of enjoyment.