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Severs- what it is, what is happening, how physio can help

What is Sever’s Disease? 

Sever’s Disease occurs when the C shaped growth plate at the back of your heel gets inflamed from stress from the achilles tendon. Growth plates are areas of cartilage located near the ends of the bones, and this is where bone growth occurs. Since it is the last part of a child’s bone to harden, growth plates are particularly vulnerable to injury. Adults don’t have open growth plates anymore, so this condition is found only in kids. Sever’s Disease is also 2-3 times more likely to occur in boys than girls, and it is associated with big growth spurts!

What my child may complain of?

  • No pain in the morning, but usually is worse with increased load during the day
  • Pain worsens with repetitive activities (example: running or jumping)
  • Tenderness on both the inside and outside of the heel
  • No swelling, redness or skin changes noted with this condition
  • Calf tightness

Things that may make Sever’s worse:

  • Worn out shoes
  • Hard surfaces
  • High amounts of physical activity
  • Big growth spurts
  • Back to activity after a long break

How can physio help?!

At Playworks Physio we specialize only in kiddos! We see kids with this type of heel pain VERY often, especially with the start of sports seasons. Your Physio will take a good look at what is happening and what might be causing it, and give lots of tools to help. Some things include stretching and strengthening activities, suggestions for activity modifications, shoe recommendations, and of course, this will all be FUN for your kiddo.

Our main goal is to help reduce your kiddos pain, solve the source of the issue to prevent it from returning, and improve their ability to participate in their activities again, pain free!

– Darrien Cantelo, Physiotherapist

 

Did you know that almost everyone is born with flat and flexible feet? In their first year, babies’ feet grow extremely fast – about 2.5cm! As children get older and start walking, their feet are still flat because the bones, muscles and ligaments are not yet fully developed.

 

Foot development

The main arch of the foot, the medial longitudinal arch, begins to form at 3-4 years of age. This arch continues to develop throughout the first 10 years of life and many studies state that the mature foot posture is not obtained until 7-10 years of age (Uden et al., 2017). This means that we should expect our children’s feet to be flat during their first 3-4 years and to then start developing an arch over the next 7 or so years.

 

Factors that can affect foot development

  • Poor fitting shoes: too small, too big, too rigid
  • Not enough barefoot time at home

 

What about those Flat Feet?

Flat feet aren’t always problematic. As you can see from above, younger kids tend to have naturally flatter feet and therefore treatment is not always necessary. If your child goes up on their tiptoes you should be able to see their arch form. This is considered “flexible flat feet”. These should not be painful. Ultimately painful flat feet in kids are a problem and non-painful, flat feet in children (or adults!) are not a problem and do not need to be treated unless they are accompanied by any of the points listed below.

 

Here are some reasons why we see kids at PlayWorks Physio for flat feet:

  • Their walking pattern is different. For example, if they do not push off from their big toe, instead they use the inside of the foot
  • Complaints of foot, ankle or knee pain
  • Bunion development on the inside of the foot
  • Frequent rolling of their ankles
  • Complaints of their feet getting tired or sore after activity
  • Excessive pronation (collapsing inwards) of feet

 

Things you can do to encourage proper foot development in your kids

  • Find properly fitting shoes. Look for shoes with a supportive heel cup and flexible sole. CLICK HERE  to learn how to pick the best shoes for your child.
  • Have your child barefoot when safe/appropriate. This helps develop the muscles, ligaments and tendons of their feet and will contribute to arch development.
  • Play around with walking on different types of surfaces. For example: grass, hills, trails, gravel, sand etc.

 

If you have any questions about your child’s foot development, email us at hello@playworksphysio.com

 

Written by: The PlayWorks Team

 

References: Uden et al. Journal of Foot and Ankle Research (2017) 10:37