This is Caleb – He Has Sever’s Heel Pain
Meet Caleb
Caleb is a healthy and happy 10 year old boy that loves playing footy. He was practicing almost every day leading up to the new season this year. At the start of the season, Caleb was barely able to finish a game without intense pain at his heel, sometimes limping off the field. Caleb was upset and frustrated that he couldn’t run and play with his friends.
Caleb’s mum, Steph, asked the other parents if they’d experienced anything similar and was told it was growing pains and Caleb just had to wait it out and maybe sit out the rest of the season.
Caleb’s symptoms, which are actually typical of Sever’s Disease, included:
- Pain at the back of the heel(s)
- Both sharp pain on activity which may radiate up the back of the leg and an ache on resting after onset of symptoms
- Pain aggravated by running, sports and physical activity
- Pain alleviated by ice, rest and anti-inflammatory medications
Steph wanted to help Caleb so they tried:
- Buying new shoes
- Strapping Caleb’s ankle and heel
- Occasional leg stretches
After 3 weeks Caleb’s pain still kept coming back when he’d run and play and hadn’t reduced in intensity. Sometimes it felt even worse.
Visit to the Podiatrist
Steph brought Caleb in to The Podiatrist after hearing that one of Caleb’s teammates had seen a podiatrist there in the past and they’d helped him with his pain.
Caleb had a thorough biomechanical assessment including checking his:
- Muscle strength
- Range of motion at all the joints of the foot, ankle, knee and hip
- Gait (walking) assessment with shoes and without, on the ground and on the treadmill
- Foot posture
- Footwear assessment
- Palpation around the heels and painful structures
Caleb’s podiatrist confirmed that he had all the signs and symptoms of Sever’s Disease. This condition is manageable and Caleb didn’t need to sit out the rest of the footy season. This is as the podiatrist was able to determine the cause of Caleb’s heel pain as opposed to labelling it ‘growing pains’ and leaving Caleb to wait it out in pain and missing out on doing the things he loves.
Treatment
A management plan tailored for Caleb was created by his podiatrists with Caleb’s goal of getting back on the field as fast as possible without pain. This included:
- Recommendations and education on the best footwear to wear at which times to help with Caleb’s pain and discomfort
- Orthotics (insoles) that reduce tension from the back of the heel and achilles tendon with every step
- Tailored stretches that work to help lengthen the calf muscles – taught correctly so they are not overdone to the point of causing additional pain/damage
- Exercises to strengthen the extensor muscles at the front of the legs like walking on heels
- Activity modification – particularly a good warm-up routine before sport and avoiding activities known to aggravate the pain such as jumping on the trampoline and riding a scooter
- Using taping to help the foot mechanics and support the achilles and growth plate
A key focus for us at The Podiatrist is not just to reduce symptoms but to identify and treat the cause of the problem so that it doesn’t keep happening. We’ve found that the combination of working on the tissues with stretches, stabilising the foot with appropriate footwear and correcting abnormal foot biomechanics and alleviating tension from damaged structures to be greatly successful in managing Sever’s disease.
We monitored Caleb’s progress and were delighted to see that by week 5, he was able to complete his footy game pain-free! His gradual progress was:
Week 1 – Pain came but was delayed to the second half of the game and Caleb felt he recovered faster afterwards
Week 2 – Caleb’s pain came on during the game but was reduced by 40% from what it used to be. Caleb came in for a review, more taping and new exercises. Everyone was happy with the progress.
Week 3 – Caleb’s pain came on but he said that it was over 50% less than what it used to be
Week 4 – Caleb felt only a little bit of pain and discomfort during the game
Week 5 – Caleb was able to complete a whole game with no pain!
Week 6 – Caleb came in for his final review and it was all green lights! We’ll review Caleb again in 6 months if nothing changes and in the meantime he’s free to be his happy and active self