Ben is 12 years old and plays soccer and basketball. He trains 3 times per week and plays 2 games per week, except when there is a tournament weekend, where he plays up to 9 games in three days. After his last soccer tournament (and he insisted on me letting you know that he won!), he ended up with left heel soreness where his Achilles inserts to the back of his heel. Ben’s calf was tight after his second game and the pain started after game four. His parents encouraged him to stretch and it felt bearable after his stretching sessions but as soon as he put on his soccer boots and started his warm-up it was sore again. By the end of the final Ben left the soccer field in tears due to the pain. His parents got ice onto it straight away and booked an appointment with me immediately.
Ben had noticeable swelling and pain at his Achilles insertion and active movement of his ankle exacerbated his pain. A diagnosis of Sever’s disease was made and you will find his treatment below, but first let’s explain what Sever’s Disease is.
Sever’s Disease, also known as calcaneal apophysitis, is an inflammation of the growth plate in a child, where the Achilles tendon attaches to the heel. This is more likely to happen in highly active children, especially those participating in repetitive sports involving running and jumping. It occurs most commonly in boys.
- Boys – ages 10-15 years old
- Girls – ages 8-13 years old
The following are the symptoms of Sever’s disease:
- Pain in the back of the heel (worse if squeezed)
- Pain worse with activity and improves with rest
- Can occur one-sided or both
- Can be aggravated by new footy or soccer boots
- May result in a limp or child may begin to walk on toes
The Chiro’s approach to Ben’s Sever’s Disease involved:
- assessing and correcting all his knee and ankle joint subluxations
- ultrasound with Trauma Relief Cream at the Achilles insertion
- assessed and fitted orthotics for Ben as he has flat feet which can exacerbate this condition
- released muscle tightness in the calves and plantar fascia using soft tissue techniques. (Note: some clients are tight enough to benefit from Dry Needling, in Ben’s case they caught it early so this was not necessary)
- Rest from strenuous activity
- Stretch - calf
- Foam roller – calf
- Calf massage
- Trauma Relief Spray and Cream (to reduce inflammation)
- Bone Aid Relief Cream and Bone Relief Spray (to assist bone healing and strength)
- Ice therapy
In Ben’s case, he was only off sport for 2 weeks, this is because it was treated early and they religiously used the Trauma Relief combination and Bone Relief Combo and followed the home care instructions well, as well as attending his 3 Chiro appointments.
Important to note:
Even if your child with Sever’s Disease rests until the pain subsides, is they are left untreated, it is much more likely to reoccur when training and games resume. It can also result in an unusual growth at the back of the heel making footwear uncomfortable.