WHY DOES MY CHILD HAVE HEEL PAIN..?
With the return of competitive sport after a year of very little, ‘Severs’ seems to be the buzzword around kids sport! What is Severs and how do we treat it?
Activity-related heel pain
Severs disease is a common condition in children aged between 8-14 years old. They normally complain of pain in one or both heels, related to activity. This is most painful following activity or after a break in the game. Children with Severs often run ‘flat footed’ to avoid pushing off properly through their foot when they are sore.
Pain is at the back of the heel, around the site of the growth plate of the heel bone (calcaneus). This bone fuses at some stage between the ages of 8 and 14 years old, and during this time in active children, the achilles tendon can pull on the attachment to the growth plate, which can inflame and aggravate the area. Latest evidence also suggests that there is an impact component to these symptoms as well, so children with a heavy heel strike when running or those landing heavily on their heels can also be more susceptible.
What are some factors that can make kids more likely to develop Severs?
A combination of factors can contribute to the development of the heel pain, such as:
Low ‘heel pitch’ in shoes – shoes that are too flat (we normally aim for a shoe that is at least 10mm higher in the heel than the toes)
Tight calf muscles
Pronated (rolled in) feet – the calf muscle has to work harder to push off when running, which means there is more force going through the heel
Sports that have high impact on the heel bone (calcaneus)
Prevention is definitely the key!
If your child is between the ages of 8-14 years old, make sure they are wearing appropriate footwear for their activity, and that you are monitoring their amount of activity, to make sure they are not overloading their young bodies.
The biggest factor that can improve the child’s comfort levels is changing their footwear. All footwear should have a 10mm ‘gradient’ from the back of the shoe to the front of the shoe. Most running shoes have this heel pitch in them, but generally football boots and basketball boots do not.
If you are concerned about your childs foot posture, then it is best to have a full biomechanical assessment conducted by a Podiatrist who can advise whether further modifications to their shoes or insoles are necessary and prescribe appropriately. Typically we prefer to use a pre-fabricated device in children combined with heel lifting.
How can we reduce the pain so they can keep playing sport?
Massage and gentle stretching is normally prescribed for the calf muscles. Ice is essential after all activity, and pain relief or anti-inflammatory gel can be used if necessary. While the heel is tender, the child’s activity levels need to be reduced. We obviously like to keep children involved in sport, so this can just be ‘stationary skills’ training during the week, then playing the game on the weekend. If they are still complaining of pain, then please discuss a further reduction in training with the coach, and see a Podiatrist.
Hopefully this advice keeps your children loving their sport in 2021 and beyond!! If you have any further questions please contact the clinic and make a time to see one of the team.
Nicki Quigley - Podiatrist, Beaumaris Vic