If your child or adolescent develops heel pain, chances are it’s due to Sever disease, which is also known as calcaneal apophysitis. Sever disease is one of the most common sources of heel pain in adolescents and most commonly affects children between the age of 6-13 who are active and involved in sports. Sever is an irritation or inflammation of the heel bone growth plate which is a result of the heel bone growing faster than the surrounding muscles and tendons. Along with repetitive microtrauma, these tight tissues cause increased pull on the growth plate, which results in pain. It is commonly seen in soccer players. Traditionally Sever used to be more common in boys; however, due to the increasing number of girls involved in organized sports, it is becoming more common in the female population.
Sever disease will eventually resolve on its own without any long-term complications. All treatments are symptom based and some children may have to decrease or take off some time from sports until the pain goes away. In some severe cases, children may have to be immobilized in a walking boot for a couple of weeks until the pain subsides. Sever patients commonly have a tight Achilles tendon, so stretching exercises are very important to help try to decrease some of the pull on the growth plate. Anti-inflammatories and ice are also recommended. Return to activity is based on relief of symptoms and should be done gradually. When returning to play, gel heel cups can be used in the cleats or sneakers in order to help provide some cushion.
—Dr. Colleen Law
Inflammation is your body’s response to injuries, trauma, illness or infections, in which your body tries to increase the blood flow to the affected area. The accumulation of fluids, however, can be painful and result in swelling, increased warmth and redness of the skin, and even bruising. Acute inflammation is the immediate response to trauma, injury, irritation or surgery, and will usually occur within two hours of the event of injury. Note that acute inflammation is different from chronic inflammation, which is more regular, does not always follow a traumatic injury, is caused by a virus or bacteria and therefore treated differently.
Acute inflammation treatment should be responded to with “RICE to the D” therapy: the age old Rest, Ice, Compression and Elevation, mixed with a Diagnosis from your podiatrist, since your podiatrist can best determine the cause of your foot and ankle pain and swelling. Remember to R: stay off your foot or ankle since pressure on it may cause further injury. I: Apply an ice pack or bag of ice to intervals of 15 minutes to the injured area, placing a thin towel between the ice and your skin. Wait for 40 minutes before icing again. Repeat as desired – the more the better! C: you can control swelling with an elastic wrap around the inflamed area, and E: raise your foot or ankle slightly above the level of your heart to reduce the swelling. Your podiatrist may also suggest that you take NSAIDs. With RICE, your symptoms will most likely improve within a few days. If your symptoms persist or worsen, be sure to see your podiatrist to receive a proper diagnosis and care.