As organised sports continue to surge and grow in popularity amongst kids, we see more and more youngsters presenting to our podiatry clinics across Melbourne, Geelong and Yeppoon. A common thing we see with kids is heel pain as they return to their favourite sports and increase their activity levels.
The most common type of heel pain in children and adolescents is known as “Sever’s Disease”. It typically presents in kids aged 8 to 14 years old and is more common in males or kids who are active.
What is it?
Sever’s Disease, technically known as “Calcaneal Apophysitis,” is inflammation of the growth plate at the heel (calcaneus). How this occurs is because the calcaneus is not fully developed until approximately 14-15yrs old in girls and 15-16yrs old in boys. The growth plate is made up of cartilage and is more prone to injury due to the tissue being weaker than the surrounding bone.
What are the Signs?
- Increased pain in the heel with activities such as running, jumping and repetitive movements
- Pain settles with rest
- Heel may then also become swollen and red, with stiffness when waking up after rest
- Pain when the heel is squeezed
- Limping or walking differently to usual
Causative factors of Sever’s Disease include:
- Rapid growth
- The discomfort will generally follow a growth spurt. The bones elongate which results in the muscles and tendons in the legs becoming tighter, which increases friction at the heel.
- Repetitive movements
- Heel pain is more common in active kids who play sports that involve movements such as running, jumping and changing direction. This repetitive movement causes increased stress on the growth plate which leads to inflammation and pain.
- Foot mechanics
- Including excessive pronation and restricted ankle mobility
What can be done?
As a parent or carer you don’t want to see your child stop playing the sport they love. Here are a few things which can be done to help.
- Stable and cushioned shoes for both exercise and everyday/school
- Shoes with a higher heel pitch will help off-load the growth plate / achilles tendon
- Ensure footwear is appropriate for activity and individual foot type
- Maximise time in shoes and avoid being barefoot
- We recommend going to a specialty footwear store to be fitted to take out the guesswork. Our favourite is your local Active Feet store
Flexible Inserts and Heel lifts
- There may be a biomechanical inefficiency that is contributing to the pain, which will need to be addressed
- Flexible orthotic devices may be indicated
- The additional of heel lifts will also help reduce symptoms in the short term
Strength and Mobility
- Soft tissue treatment and massage is recommended to release tightness within the calf muscles while it is adapting to growth
- Increasing strength in the calf and further up the chain will help control foot movement and increase shock absorption