Sever’s Disease generally occurs in active children, between the ages of 9 – 14. It is caused by repetitive pulling of the achilles tendon (the large tendon behind your ankle) against the heel bone, known as the calcaneus. As with every other bone in the body, a child’s calcaneus has a growth plate, that is situated at the back of the bone. This allows the bone to grow appropriately during the developmental years. In active children, that do a lot of running or jumping, the achilles tendon tightens and starts to pull excessively on the growth plate in the calcaneus. This starts to cause micro-damage to the growth plate and it gradually starts to become inflamed. Sever’s can be extremely painful and debilitating, however, it generally responds quickly, to early treatment. FNQ Podiatry and Orthotics provide professional Sever’s children’s heel pain treatment. Cairns clinics are located at Earlville and Redlynch, with another in Mareeba.

• Pain at the back of the heel, particularly during and/or after running or jumping.
• Some patients have pain underneath the heel, but the majority is around the sides and the back of the heel.
• Pain walking first thing in the morning, particularly after training or playing sport the night before. This often warms up as the child starts walking for 5-10 mins and can be pain free until they start running again.
• Please note it is rare to see any swelling or bruising with Sever’s.

A thorough biomechanical assessment, Cairns VALD Strength Testing and detailed history will most commonly be enough to diagnose Sever’s. Depending on the severity of symptoms, you may/may not be referred for an x-ray or ultrasound to rule out any other issues however this is rare.

Treatment options are largely tailored around addressing the individual risk factors. Given this, your initial consultation will involve a thorough foot and lower limb biomechanical assessment, to determine what your contributing factors are. As with most foot problems, it’s best to quickly implement children’s heel pain (Sever’s) treatment Cairns, to reduce the chances of it turning into a chronic condition.

Common Treatment Options Include

• Moderated rest. As Sever’s is an over-use injury, the most important first line treatment recommendation is reducing activity levels. This often starts with unnecessary activities such as running around on weekends or in the child’s lunch breaks at school. This is to try and keep them participating in their desired sport. Severe cases can result in the patient having to take a short amount of time off running to help allow the heel bone to settle down.
• Strapping/taping. Helps to reduce the tension of the achilles tendon on the growth plate.
• Massage through the calf muscles. The looser the calf muscle is, the less tension there is in the achilles tendon, and therefore the less pulling against the growth plate of the heel.
• Footwear modifications. We commonly place heel wedges in the back of the child’s shoes to help get their heel up off the ground and therefore reduce tension in the achilles tendon.
• Soft, custom orthotics. These help off-load the achilles and reduce pulling against the heel as well as stopping the foot/ankle from rolling in (only used if biomechanically required).
• Strengthening program. To address any underlying weaknesses and to progressively load the tendon.
• Moon boot. These are rarely used and are only required for chronic, painful cases that don’t respond to conservative treatment.

Whilst Sever’s is a common condition, it should be treated as early and aggressively as possible. Symptoms often start quite mild, so parents hold off on getting treatment until their child starts limping. During this time, it can turn into a chronic condition, leading to a significant increase in recovery time. Fortunately, Sever’s tends to respond really well to the above conservative treatment options, assuming there is a high level of compliance from the child and parents. FNQ Podiatry and Orthotics provide professional children’s heel pain (Sever’s) treatment Cairns. So, if your child is suffering from pain at the back of the heel, and its impacting on their sport, contact our clinic today and we will get them on the road to recovery.

Whilst any child between the ages of 9 – 14 can develop Sever’s, there are some common risk factors that we have identified, that significantly increase the chances of suffering from heel pain. They include:

• Over-activity. Sever’s is extremely common in children who are playing multiple sports during the week and on weekends. This is particularly true for sports that involve a lot of running/jumping such as basketball, soccer, netball etc.
• Children with tight calf muscles. The tighter the calf muscles, the tighter the achilles tendon is and therefore, the more tension there is at the growth plate.
• Children who experience rapid growth spurts. This leads to tightening of the calf muscles and achilles tendon as per above.
• Poor quality footwear. The growing foot is vulnerable to injury, particularly if they aren’t supported by the appropriate footwear.
• Feet that roll in (pronate). When the foot and ankle rolls in, it leads to a bowing of the achilles tendon and therefore causes more pulling against the growth plate of the heel bone.
• Sudden increase in physical activity. Sever’s is extremely common February – April in Australia, as it is during pre-season for winter sports. If activity levels are suddenly increased, the achilles tendon and bone don’t have time to adapt and therefore gets aggravated quickly.
• Sports involving hard surfaces. Hard surfaces leads to increase load being placed through the feet, particularly the heels e.g. basketball or netball.