A few months ago, my youngest son, age 12, began to complain about his feet hurting a lot. I chalked it up to the proverbial “growing pains” and did not really think much about it, as he seemed to get around fine and the pain would come and go.
Over the next few weeks, he complained about the pain getting worse, so I arranged for him to visit the podiatrist. Upon examining my son’s feet, the doctor indicated that this is a common problem and that once my son finishes growing, it should go away.
Upon doing further research on the internet, it appears my son has Sever’s disease. Although the podiatrist did not refer to the condition as such, the symptoms my son has seem to parallel those I discovered through my research. I stumbled upon a page on Sever’s disease, which is a common cause of heel pain that occurs in children when the growth plate, which is the growing part of the heel, is injured. The foot is actually one of the first parts of the body to grow to full size. (I could have told you that! You should see the size of shoes my son now wears!) This typically happens in the early stages of puberty. During this time, the muscles and tendons cannot keep pace with the rapidly growing bones. As such, those muscles and tendons tighten up and the area around the heel is not as flexible as it was. When the child participates in any weight-bearing activity, the tight heel tendons can put excess pressure on the back of the heel injuring it, resulting in the condition known as Sever’s disease.
Children are most at risk for this condition in the early stages of puberty or in the early part of a growth spurt. It is common in girls ages 8-10 who are physically active and in boys ages 10 to 12 who are physically active. This made sense to me, as my son had just begun working out and had taken an interest in running for exercise.
Sever’s disease is commonly seen in children who participate in soccer or gymnastics, but any activity requiring running or jumping can contribute to it. It is not usually seen in older children, as the back of the heel has basically finished growing by age 15.
When a child has Sever’s disease, he or she might notice heel pain in one or both heels. It usually flares up after the child begins a new sports season or a new sport. You may notice that your child walks with a limp or even has a tendency to tip toe. I noticed that in our daily afternoon runs, my son would occasionally run on his toes. Your child may have pain when you squeeze both sides of his heel towards the very back of it. This is referred to as the squeeze test. In addition, your child’s tendons may be tighter than normal.
To treat this condition, your child should reduce or stop any activity that may have caused the pain. An ice pack to the injured heel for 20 minutes, three times a day can help. Your doctor may recommend orthotics, arch supports, or heel cups. Do not let your child go barefoot. We opted to get over-the-counter orthotics for my son, which have seemed to help, although, at this point, he cannot wait to turn 15, as that is when the doctor indicated this problem should go away.
The podiatrist also suggested that my son engage in some daily stretching exercises that allow the hamstring and the calf muscles to be stretched, as well as the tendons on the back of the leg. Done up to three times a day, the stretches should be held for about 20 seconds. Both legs should be stretched, even if the pain is in just one heel. The exercises our podiatrist recommended included having my son stand on a step with half of his foot firmly on the step and the back half over the edge of the step. He instructed my son to stretch his feet downward and hold for 20 seconds and then come back up. He also suggested that my son sit on the floor with his legs stretched out in front of him. Using a towel that is wrapped around his foot, he should pull both ends of the towel towards him while stretching the leg muscles and foot away from him.
With proper care and treatment, your child’s pain should diminish within a couple of weeks to a couple of months. Once the pain is gone, your child should be able to return to playing sports. However, do so under the guidance of your doctor.
There are no long-term problems associated with this disease. However, if your child continues to experience pain and does not seem to be getting any better, despite the treatment measures, be sure to let your doctor know.
The key to preventing Sever’s disease is to encourage your child to maintain good flexibility while he or she is growing. Stretching exercises can reduce the risk for injuries during a growth spurt. Be sure to check into good quality shoes that offer firm support and a shock-absorbent sole. It is best to have your child avoid excessive running on hard surfaces.
My son’s feet are getting better, but he still has pain from time to time. He has found that when he mixes up his exercise routines, it helps. He has gone from running every day to discovering the joy of the elliptical machine! He has also discovered that this is an ideal time to ask for those more expensive and durable shoes, as “they are better for my feet, Mom!”
(Information for this post was found at http://familydoctor.org/online/famdocen/home/healthy/physical/injuires/158.html)