Thursday, July 11, 2019

We would like to talk about a common heel pain condition that we see in children and adolescents between the ages of 8-16. Sever's Disease or Calcaneal apophsitis is a growth plate injury of the heel often misdiagnosed as plantar fascitis. We are starting to see this injury more often most likely because of year round travel sport teams as well young children specializing in one sport without  variety as well as much needed rest. This is typically an overuse injury of the growth plate of the heel. The heel bone is called the "calcaneus" and has an important growth plate at the base. Boys from 8 to 14 and Girls 7 to 13 can have pain develop in this area either from the pull of the achilles tendon, or the pull of the plantar fascia. We see this in sports such as basketball, running, baseball, gymnastics, and tennis. After those ages, the growth plates will fuse and there can no longer be a source of pain. This form of heel pain can disrupt activity and be frustrating for children as well as their parents. If recognized and diagnosed promptly, conservative treatment will usually resolve this condition rather quickly.

     The basic rule is to create a pain free environment with no limping. Treatment consist of ice, oral NSAIDS, stretching, achilles/plantar fascial night splint, heel lifts/heel cushions, custom orthotics, physical therapy, and in extreme cases cam walker boot/cast immobilization. Physical therapy modalities such as electrical stimulation, iontophoresis, dry needling of the calf, and achilles stretching can be useful ways to resolve this condition. Brief modification of exercise routine to more low impact can help the growth plate to heal.

If your children are suffering from heel pain it is important to have them seen as soon as possible. The faster that this condition is recognized and treated the quicker your children will have resolution of heel pain which will allow them to resume to the sports that they love to participate in.

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