If you have an active child, you are probably used to minor injuries like sprains, strains, and bruises happening once in a while. What you may be unprepared for, however, is chronic pain and inflammation.

If your child is experiencing chronic pain in his heels, you probably have many questions and concerns. Isn’t he too young to experience chronic pain? Is this an injury, or is there an illness or something broken? Will there be long-term damage?

Perhaps the most important question of all: what is causing this pain?


What is Sever’s Disease?

If your child is experiencing heel pain and swelling coupled with difficulty walking, he or she may be showing signs of a common childhood condition known as Sever’s disease. Sever’s disease is the result of a mismatched growth rate between a child’s heel bone and ligaments; the heel bone grows much faster than the Achilles tendon, so the Achilles and connected muscles can become very tight as the child grows. As pressure increases on the tendon, the heel bone can become damaged.

Sever’s disease is usually found in active, growing children between the ages of eight and fifteen years old. Kids who are most at risk are those whose activities— such as basketball, ballet, and track—expose them to heel contact with hard surfaces. Other risk factors include regularly wearing shoes that do not fit well (common enough when children are growing quickly) as well as standing for long periods of time, which may apply to youngsters participating in marching band or other activities.


What Should I Do for My Child With Sever’s Disease?

If you notice that your child is experiencing heel pain frequently after activities or after waking up, you should take immediate steps to ensure that permanent damage does not occur. Sometimes, simple things such as decreasing the child’s sports activities for a while can make a significant difference in pain. Applying cold packs to the heels after activity can also help reduce painful inflammation in the area, as well. Avoid hard shoes, rest, ice and ibuprofen can be helpful. Once you have it, getting a good arch support with some cushion is very helpful. This biomechanical control can lower the stresses going through the heel bone.

Nutrition: Selenium 200 Ug and Vitamin E 400 IU has been suggested as helpful (check out Oscon on the internet). Some authors have recommended L Arginine in low doses (1 gram a day). In higher doses it can make kids grow faster. These seem to work by increasing blood supply to the area. It also makes sense that taking enough calcium (1000 to 1500 mg a day for kids 4-18) and Vitamin D helps bone heal. Several large-scale studies have found that vitamin D deficiency is widespread —one in 10 U.S. children are estimated to be deficient — and that 60 percent of children may have suboptimal levels of vitamin D. If your child has heel pain your physician should probably check his or her Vitamin D level. In these days of inside activities, and sunscreen it is difficult make enough Vit D.

Immobilization: Sometimes casting and non-weight bearing are needed. This is rare but sometime necessary.

If the symptoms continue or are more severe, seeing a podiatrist can help you ensure that your child does not suffer permanent damage to his heel bones, tendons, or leg muscles. While many children eventually outgrow Sever’s disease, alleviating the symptoms can help your child live pain-free while he grows.


What Are My Child’s Treatment Options?

At Next Step Foot & Ankle Clinic, we can develop a custom treatment plan for your child. Starting with a simple routine of stretches that focus on lengthening the calf muscles and Achilles tendons, we can also explore more aggressive options like orthotic shoe inserts, tendon or arch taping during activity, or regular physical therapy.

Dr. Silvester can provide a comprehensive assessment, treatment plan, and follow-up care for your child in order to help him return to the activities that he loves and enjoy a daily life without pain. You do not need to “wait out” Sever’s Disease; take action now and call us at 855-972-9512 to schedule an appointment with the Next Step team today!