Soccer and heel pain. They go together like peanut butter and jelly. We treat a lot of 11- to 12-year-old kids with acute heel pain during the soccer season. A common cause for this discomfort is called Sever’s disease.
It’s Not as Scary as it Sounds!
No, it’s not nearly as scary as you might imagine. Sever’s disease entails the inflammation and swelling of the growth plate in the heel. You could easily replace the scary term with the friendlier name of “growth plate swelling.” It’s most common in kids who are active in sports, hence the connection to soccer.
At the ends of your developing bones are growth plates where cartilage eventually turns to bone. In the heel, this particular growth plate can sometimes grow faster than the muscles and tendons attached to it, which causes a lot of stress. The tendons become tight, stiff, and less flexible—especially the Achilles tendon, which is the largest tendon attached to the growth plate. With overuse, the tendon can cause too much pressure, resulting in the growth plate becoming inflamed, swollen, tender, and damaged.
Excess Pressure Equals Excess Pain
Any excess weight on the heel will aggravate this problem in young adolescents. Sports like soccer, basketball, football, gymnastics, track, and any other activities that require sprinting and jumping, tend to put your child at a higher risk for heel pain. He or she may also feel pain after standing for too long and wearing bad shoes. Both of these activities might put too much pressure and impact on the heel.
Foot structure can play a big part, too. Flat feet, high arches, and a foot that overpronates can contribute to the problem. In addition, if your child has a leg that’s shorter than the other, the shorter leg can pull too much on the Achilles tendon. Being overweight or obese can also be a risk factor for Sever’s disease.
Symptoms of Stiffness, Pain, and Swelling
Children may feel pain and stiffness in their heels while walking, running, or after a long period of resting the area. Squeezing the heel can be painful too. A dull ache might also be another symptom.
As far as visible signs, you’ll be able to see redness and swelling in some cases. Coaches, parents, and caretakers need to watch for walking adjustments as an indicator of this disease. Some kids will try to find ways to get around the pain, developing a limp, walking or running on their toes, and lifting their heel earlier when taking a step.
Kick Pain to the Curb
The first thing we’ll advise is to rest and ice the foot. During this time, we may recommend oral anti-inflammatory medications. We might have your child try a protective boot and crutches, if the pain is severe enough. Exercises and stretching can also rehabilitate the heel once the initial resting period is over.
It’s important for your child to rest the foot and avoid the activity that caused pain. Complete recovery time can take two weeks to two months. With proper care, the symptoms will go away faster than if the condition is ignored.
Prevent Pain with Well-Fitting Shoes and Orthotics
To prevent the pain from coming back, your child should wear good shoes that fit. These shoes should have a cushioned sole to absorb the impact placed on the heel when the foot hits the ground. That doesn’t mean the shoe has to be expensive, it just has to fit well.
If your child has a poor foot structure like flat feet or high arches, we can create a pair of custom orthotics that will keep the problem from coming back and prevent more from happening.
The best way to prevent Sever’s disease is to get your kid in for a foot exam before the problem starts. Call the McDowell Orthopedics & Podiatry Group at (916) 961-3434 and schedule an appointment with Dr. Brian McDowell or Dr. Gavin P. Ripp. Our office in Carmichael, CA, serves Citrus Heights, Roseville, Sacramento, Fair Oaks, and Rocklin.
Photo Credit: Graur Codrin