By Matthew Paden
The Perfect Recipe
Start with your child’s foot. When your son or daughter begins to leave childhood behind and enters the adolescent years (approximately 8-10 years old for girls, age 10-12 for boys), they go through a growth spurt. During this time, the heel bone (calcaneus) can grow faster than the tendons and muscles in their legs. This stretches the soft tissue bands and makes them tight. As a result, they pull against the calcaneus where they are attached.
Now add in activities like running, jumping and landing, twisting and turning—all the common movements your child will perform during a sports activity like soccer, gymnastics, basketball, or track and field. In the heat of the action, these repetitive motions cause the tight tendons to pull even more, and the increased tension can damage the growth plate that lies in the middle of the heel bone. This area of cartilage—which eventually hardens and fuses—can become swollen and tender. The recipe is complete, and your child will feel the pain in the back of the heel.
Testing the Ingredients
There are several factors that contribute to this recipe for discomfort. You can check your child for these conditions. Overpronation causes the ankle to roll too far toward the inside as your child moves, putting extra stress on the Achilles tendon. If one leg is shorter than the other, the shorter leg has to reach farther to contact the ground, stretching the Achilles. If your child’s arches are too high or too low, they change the angle of the heel and increase tension in the tendon. Being overweight puts added stress on the foot bones, too, including the heel.
Developing a Dish of Discomfort
When your child’s age and growth spurt are combined with foot characteristics and activity, the result is a dish of common symptoms. Although all may not be present, watch for these signs of Sever’s disease: heel pain, especially if you squeeze the calcaneus itself; red or swollen spots at the back of the heel; stiff feet in the morning; a limp or odd gait; or hesitancy to walk because it hurts when they do so. If you notice any of these, bring your child in for an evaluation. By manipulating the foot and asking about symptoms and activities, we can usually pinpoint the cause. Although this condition cannot be seen on an X-ray, we may want to order test images if warranted to make sure nothing is broken.
Sever’s Disease: No Treat, but Treatable
No one wants to see their kids in pain, so relieving that symptom is the first priority. That requires rest and keeping the weight and pressure off from the heel for a while. We may be able to suggest alternative activities that have less impact.
Meanwhile, we can also show you how to ice the heel and apply a compression wrap to bring down swelling and pain. There are certain pain relievers and anti-inflammatory medicines that can help, but check with us first about which are appropriate for your child.
There are also stretches that help lessen the tension in your child’s hamstrings, calf muscles, and Achilles tendons. This will decrease the pull on the heel bone and aid in the healing. The stretches can also keep the problem from returning. Take heart—this condition won’t last forever. Once your child stops growing, the calcaneus hardens and the pain will disappear.
If you need more information, or you think your child has Sever’s disease, don’t hesitate to give Rocky Mountain Foot & Ankle Center a call at (303) 423-2520 and set up an appointment at our Wheat Ridge, Golden, Granby, or Evergreen, CO office. We will help you get your child’s foot back in great shape to enjoy their favorite sport once again.
Photo credit: photostock via freedigitalphotos.net