TREATING KIDS WITH SEVER’S DISEASE

written by Natalie Rinaldi

In my blog today, I am going to talk about a common condition I deal with on a weekly basis, Sever’s Disease. Being a sports clinic, practitioners at Melbourne Muscular Therapies Richmond/Kilsyth  commonly treat a lot of children with a condition known as Severs. It is quite difficult to deal with children with Severs as they are unsure why they’re in pain, not sure how it happened, and sometimes are very upset, due to the condition being quite painful. If your child suffers from pain after physical activity, you should send them to us, we will be able to help them, relieve them from pain and give advice on how to avoid the flare ups.

Severs is a very common condition children between the ages of 8-15 suffer from. This is because they are at their peak age of going through puberty, where their body starts to shape, grow and prepare for adolescent years. Not all children experience severs, but it is known that a higher percentage of children who suffer from these types of pains are the ones physically active on a regular basis eg, competitive sports, coaching sports, sports which involve multiple nights a week of training.

For those who are not exactly sure what sever disease is, severs is the inflammation of the growth plate in the heel of the foot at the calcaneus bone. This inflammation occurs from repetitive use or heel strike on the ground or a heavy surface- a lot of running and moving. This inflammation is caused by the growth spurt that children go through in early adolescent years, causing an irritation and inflammation to the calcaneus bone at the base of the heel. Severs however can also be brought on with factors such as poor foot mechanics due to poor footwear, decreased ankle range of motion which does not allow the ankle to move properly when walking and running and tight musculature which causes excessive load, pulling and strain into that growth plate and pulling into the calcaneus.

Treatment of severs does involve a few stages:

1. Inflammation stage- In this stage, your child will just be presenting with pain in the heel or base of their foot. In these early stages, ice and rest should be the best approach for your child as soon as they feel the onset of pain or complain of pain in the calve and foot.
2. Treatment stage- In this treatment stage, what I do is assess the child in regards to movement and range from hip down, looking for any signs of poor movement and dysfunction. The foot mechanics are also assessed here, assessing the musculature of the foot as well as surrounding muscles up the calf, also assessing the way the foot works in regards to heel striking and jumping. This gives a very clear indication of the way your child foot is shaped, what may be causing the severs to be more inflamed and best areas to treat first. Following these assessments I then treat with the solidifying tissue technique we specialise with here at Melbourne Muscular Therapy. This involves a slow, deep treatment through the posterior calve muscles, all the way down to the ankle, then following Positional Release Technique of the ankle. This involves the child actively moving as I clean out the ankle joint from blockages, which will increase their ankle range. Following treatment taping the calcaneus under the foot allows the child to have some support under the heal, illuminating direct hard contact with the ground. All my clients have benefited from this taping very much!

• Foot mechanics- Once treatment is finished following our principles of cleaning and solidifying tissue through the calve and ankle structures, foot mechanic exercises are then given to the child. From the assessments done before treatment, we are able to pick up areas of the feet that may be causing the severs to be brought on, or what may be causing such severe inflammation, so exercises are given for the child to do daily to improve their feet biomechanics and foot and toe intrinsic. Although we give exercises, it may not fully eliminate the pain, remember the pain is caused from that growth plate movement, however by improving the foot intrinsic with a child, their foot will be able to move and function and a lot better, and thus reduce the extremity of the inflammation or pain they may be feeling!

 

Common questions:

1. Does my child need orthotics?

Orthotics are a treatment tool podiatrists use to change the structure of the foot or whatever reason someone may present with. Although they do work for a lot of people, orthotics are not a healthy tool to fixing problems with the feet, if anything do make things worse. Here Melbourne Muscular Therapies, we are big believers of bare foot training. This is so your feet gain strength, have strong proprioception and have a natural shape and healthy connection with the ground. With orthotics, your foot is changed to adapt to the orthotic which may fix the foot issue but is 80% more likely to cause other body issues in the future. Hands on treatment with the foot whether it be for severs or any pain, is the best treatment there is!

2. Will my child have severs pain forever?

No. Normally as said above, severs is common in children going through that puberty stage. Here is where the growth plate is at its more vulnerable and is moving the most, causing that bone inflammation. It is common for your child to have severs either mild of severe for a couple of years at their biggest growing period however does change and reduce immensely after this stage.

3. Should I buy different shoes for my child?

All shoes are bad! What shoes do are give a fake support under the foot, that change the biomechanics and foot intrinsic of every single foot! However, it is not possible to be bare foot every single second of everyday life. You do not necessarily need to buy your child new shoes however, shoes that are worn, especially runners which is what children will be wearing 99% of the time they are running or being physical should have as flat of a base as possible. This is so their foot is not forced to have an unnatural heel rise and then forced to run on that heel lift.

 

Have any questions or concerns? Want some advice? Come in and see me or any of the practitioners here at Melbourne Muscular Therapies and we will help you!