Severs – A real pain in the heel for kids

As parents, we often expect our children to be full of energy and vitality, bounding around without a care in the world. So, when they complain of heel pain, it can be concerning. One condition that commonly affects children, particularly those who are active, is Sever’s disease. Despite its intimidating name, Sever’s disease is a relatively common and treatable condition. In this article, we’ll delve into what Sever’s disease is, its causes, symptoms, diagnosis, treatment options, and how parents can support their children through it.

What is Sever’s Disease? Sever’s disease, also known as calcaneal apophysitis, is not actually a disease but rather a painful inflammation of the growth plate in the heel bone (calcaneus). Growth plates are areas of developing cartilage tissue near the ends of long bones in children and adolescents. These plates are vulnerable to injury because they are weaker than surrounding tissues.

Sever’s disease typically occurs during the growth spurt of adolescence, usually between the ages of 8 to 14 for girls and 10 to 16 for boys. It is commonly seen in children who participate in sports or activities that involve running and jumping, such as soccer, basketball, gymnastics, or track and field. The repetitive stress and impact on the heel bone during these activities can irritate the growth plate, leading to inflammation and pain.

The hallmark symptom of Sever’s disease is heel pain, particularly during or after physical activity. The pain is usually located at the back of the heel, where the Achilles tendon inserts into the calcaneus. The affected heel may also be tender to the touch, swollen, or red. Children may limp or walk on their toes to avoid putting pressure on the painful heel.

Diagnosing Sever’s disease typically involves a physical examination by a healthcare professional. The doctor will review the child’s medical history, ask about their symptoms, and perform a thorough examination of the affected foot. X-rays may be ordered to rule out other causes of heel pain, such as fractures or growth plate injuries.

The good news is that Sever’s disease usually resolves on its own once the growth plate has fully closed, typically by the age of 14 to 15 in girls and 15 to 17 in boys. However, in the meantime, there are several treatment options to help manage symptoms and promote healing:

1. Rest: Encourage your child to take a break from activities that exacerbate the pain, such as running or jumping. Low-impact activities like swimming or cycling may be more tolerable.
2. Ice: Applying ice packs to the affected heel for 15-20 minutes several times a day can help reduce inflammation and alleviate pain.
3. Stretching: Gentle stretching exercises for the calf muscles and Achilles tendon can help relieve tension and improve flexibility.
4. Supportive footwear: Ensure your child wears supportive shoes with good cushioning and shock absorption, especially during physical activity.
5. Heel pads or orthotic inserts: These can provide additional cushioning and support for the heel, reducing pressure on the growth plate.
6. Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help alleviate pain and inflammation. However, always consult with a healthcare professional before giving any medication to children.

It’s essential to follow the treatment plan recommended by your child’s healthcare provider and to be patient, as healing may take several weeks to months.

Supporting Your Child: Dealing with heel pain can be frustrating and discouraging for children, especially if it affects their ability to participate in activities they enjoy. As a parent, you can provide emotional support and encouragement to help your child cope with Sever’s disease:

1. Listen to your child’s concerns and validate their feelings.
2. Encourage them to communicate openly about their pain and any limitations they may be experiencing.
3. Be patient and understanding, and avoid pressuring them to participate in activities that cause discomfort.
4. Work with their healthcare provider to develop a treatment plan that addresses their needs and goals.
5. Keep them engaged in alternative activities that they enjoy and can participate in comfortably.

Conclusion: Sever’s disease is a common and temporary condition that can cause heel pain in children and adolescents, particularly those who are active in sports. While it can be frustrating to deal with, especially for young athletes, the good news is that Sever’s disease typically resolves on its own with time and appropriate management. By understanding the causes, symptoms, diagnosis, and treatment options for Sever’s disease, parents can provide the support and guidance their children need to navigate this challenging time and return to their active lifestyles pain-free.