Sever's Disease in Young Kids: Understanding and Managing Heel Pain

Overview

• Common in kids aged 8-14 who play sports and do a lot of running.
• Associated with growth spurts where bones grow faster than muscles and tendons, specifically the Achilles tendon.
• Leads to inflammation and tenderness at the heel, particularly during physical activities.

Symptoms

• Pain is located around the heel area.
• Can lead to redness and severe tenderness, especially after jumping, running, or playing sports.
• Severity varies; some kids have mild discomfort while others may need to stop playing sports due to pain.

Diagnosis

• Important to differentiate between Sever's disease and tendonitis.
• Tenderness at the Achilles tendon insertion point is a key indicator of Sever's disease, not tendonitis.

Management and Treatment

Taping Technique

• Anchor point taping: Helps support the Achilles attachment point to reduce pain and provide stability.
  • Tape the back of the heel and pull it down to lock it in place.
  • Use multiple strips, and add tape underneath the heel for extra support.
  • Also consider kinesio taping up the calf to support the Achilles tendon.

Activity Modification

• Rest from aggravating activities: Essential if the pain is severe.
• Manage sports participation: Reduce training, skip games, or limit playing time as needed to avoid aggravation.
• Important to balance rest with maintaining some level of activity to prevent weakness.

Strengthening Exercises

1. Isometric Loading
   • Single-leg calf raises: Helps maintain and build strength in the calf while alleviating tension on the Achilles tendon.
   • Straight knee position: Raise up on toes with knee straight, hold for 20-40 seconds.
   • Bent knee position: Bend the knee slightly while holding the raised position to target the soleus muscle.
2. Eccentric Strengthening
   • After initial isometrics, progress to eccentric calf raises.
   • Go up on two legs, then lower down on one leg (slowly).
   • Aim to increase strength at the insertion point of the Achilles tendon.

Stretching Exercises

• Calf stretches: Important for flexibility and reducing tension on the Achilles tendon.
  • Use a step or block, with forefoot on the edge and heel dropped down.
  • Straight knee stretch: Focuses on the gastrocnemius muscle.
  • Bent knee stretch: Targets the soleus muscle.
  • Hold each stretch for 30-60 seconds, aim for three sets per day.

Footwear and Orthotics

• Supportive shoes: Opt for structured, supportive shoes such as Asics GT to reduce load on the Achilles.
• Heel raises or orthotics: Consider using heel raises or custom orthotics to help manage pronation and alleviate pressure.

Conclusion

• Consult a physio to get an appropriate diagnosis and treatment plan.
• Proper taping, strengthening exercises, and footwear adjustments can significantly help manage and reduce heel pain associated with Sever’s disease.

Always assess individual needs and adjust treatment accordingly.

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