Severs disease and plantar fasciitis

What is it?

• Sever’s Disease: This is a common cause of heel pain in growing children, especially those aged 8 to 14. It occurs when the growth plate in the heel becomes inflamed due to repetitive stress. It’s not actually a disease but an overuse injury that affects active kids, particularly those involved in sports like soccer, basketball, or gymnastics.
• Plantar Fasciitis: This condition occurs when the thick band of tissue that runs along the bottom of the foot (the plantar fascia) becomes irritated or inflamed. It’s less common in children but can happen, especially in those with flat feet or high arches. It typically causes pain in the heel or arch of the foot.

What causes it?

• Sever’s Disease: It’s caused by repetitive stress and pressure on the heel’s growth plate, often from sports or physical activities. Rapid growth spurts, tight calf muscles, or poorly fitting shoes can also contribute.
• Plantar Fasciitis: This is usually caused by overuse, excessive running or jumping, poor footwear, obesity, or biomechanical issues like flat feet or high arches.

Symptoms

• Sever’s Disease:
  • Heel pain, especially during or after physical activity
  • Swelling and tenderness at the back of the heel
  • Limping or walking on tiptoes to avoid heel pain
• Plantar Fasciitis:
  • Sharp heel pain, usually worse in the morning or after rest
  • Pain after long periods of standing or after exercise
  • Tenderness along the arch of the foot

Possible complications

• Sever’s Disease: Complications are rare but may include chronic heel pain if not properly managed.
• Plantar Fasciitis: Chronic pain and changes in walking patterns, which could lead to knee, hip, or back problems.

Treatment options

• Sever’s Disease:
  • Rest and reduced activity
  • Ice application to reduce inflammation
  • Stretching exercises for calf muscles
  • Supportive footwear or orthotic inserts
  • Pain relievers like ibuprofen (under medical supervision)
• Plantar Fasciitis:
  • Rest and activity modification
  • Stretching exercises for the Achilles tendon and plantar fascia
  • Ice application and anti-inflammatory medication
  • Orthotic supports or heel pads
  • Physical therapy or, in severe cases, custom orthotics

Recovery

• Sever’s Disease: Usually resolves within a few weeks to months with proper rest and care. It typically does not cause long-term issues.
• Plantar Fasciitis: Recovery can take several weeks to months. Consistency with stretching, proper footwear, and rest is crucial for complete healing.

Prevention

• Sever’s Disease:
  • Encourage wearing supportive, well-fitted shoes
  • Promote stretching before and after activities
  • Gradually increase physical activity intensity
• Plantar Fasciitis:
  • Ensure proper footwear with good arch support
  • Maintain a healthy weight to reduce foot stress
  • Stretch regularly, particularly the calf and foot muscles

Frequently Asked Questions

Q: Can my child continue sports with Sever’s Disease or Plantar Fasciitis?
A: It’s best to rest until pain improves. Continuing activity can worsen the condition.

Q: Will my child need surgery?
A: Surgery is extremely rare for both conditions and is only considered if conservative treatments fail.

Q: Can these conditions come back?
A: Yes, especially if the child returns to intense activities too soon or without proper footwear and stretching.

Q: Is it okay to use painkillers?
A: Over-the-counter pain relievers like ibuprofen can help but should be used under medical supervision.