Heel pain in adolescents can significantly limit their ability to keep playing the sport they love. Severs disease is the most common cause of this heel pain.
Unfortunately, adolescents with this issue are often told that Severs Disease is something they just have to put up with until growing stops, but this is not the case. Physiotherapists can successfully manage this issue to minimise its impact on sport and day-to-day life.
First of all, what happens during Severs Disease? During growth spurts, bones lengthen first, and it takes a while for the muscles to catch up. As the shin bone (tibia) lengthens during the growing process, the calf muscles (gastrocnemius and soleus) become relatively short compared to the shin bone. The calf muscles are now under tension and this causes a “traction” force where the calf muscle attaches to the heel bone (calcaneus). This attachment site can then become quite painful and a physical lump can often be felt.
There are multiple factors to be considered when treating Severs Disease, but here are my big three to start with:
- Stop stretching your calf muscles! We know that Severs Disease is caused by relatively short calf muscles, so it is intuitive to want to stretch these muscles. However, stretching the calf muscles will create further pulling/traction where the muscle inserts, leading to further irritation. So, at least in initial stages, put calf stretching on the back shelf!
- Start foam rolling or massaging! Stretching is not recommended. But we do want to loosen the calf muscles to take the tension off its attachment point. A great alternative to stretching is foam rolling or deep tissue massage. In initial stages of management, when pain relief is king, your foam roller will be your new best friend!
- Get strong! Now that you have done your share of foam rolling or massage, it’s time to get strong. A targeted strength program for the calf muscles will help to remove the load from the heel. However, don’t focus only on the calf – other muscle groups such as the glutes, quadriceps and hamstrings are also very important. Your Physiotherapist can design a tailored program for you.
Whilst these are three things which can be considered when treating this issue, it is not an exhaustive list. Load management (reducing activity or spreading it through the week), modifying footwear and manual therapy to compliment foam rolling are commonplace amongst many other options.
Severs Disease is not something that you just have to put up with – it can be managed well to get you back doing the things you love!
This article is written by Tom Collier, Physiotherapist at Back In Motion Eltham.
If you would like further information, please contact our practice on 9439 6776 to book in a consultation with Tom.