Sunday, October 7, 2007
Ouch My Foot Hurts
I shaved my son's legs this weekend. Who would have thought that a nine year olds' legs are so hairy!
I shaved his leg because his foot was hurting.
No, I am not completely crazy. My nine year old, and now my ten year old, have Sever's Syndrome. They were diagnosed after I took them to an orthopedist specializing in adolescent sports issues. The symptoms are: painful swollen heel, stiffness in the heel and lower calf in the morning or after sitting for a period of time, and limping.
I took my nine year old in because he said, "Mom, my foot really REALLY hurts." This is a kid who has a very high tolerance for pain (more on that later), so I immediately made him an appointment. The foot had been hurting for a month or so and soccer season was just about to be in full swing. I immediately started worrying and imagining this very active kid in a cast. It freaked me out. I was more nervous for the appointment than he was. The doctor carefully examined his foot, manipulated all the bones, moved it in all directions, "does this hurt?" and "what about this, does this hurt?" About five minutes later, he told me, "Your son has Sever's Syndrome. Have him take Aleve for 10 days and use these gels in his shoes. It will go away in a few months." Huh? What is Sever's? He wrote it down for me and told me to "look it up on the internet there's lots of information there call me if you have any questions thanks for coming NEXT!!!"
OK, so Sever's Syndrome is not that exciting for an orthopedist, but I'd never heard of it. And my son has it, so I better know what the heck it is! I soon learned that Sever's is fairly common. Many boys suffer from it but don't know what it is or how it can be treated. So I thought I'd share for all those moms of active boys (and girls).
From my research:
Sever's syndrome is a painful heel condition that affects growing adolescents between the ages of nine and 14. In this condition, the growing part of the heelbone grows faster than the tendon that connects on the back of the heel. This tightens up the tendon and creates tension where it attaches to the heel. Eventually, the tension causes the area to become inflamed and painful. Fortunately, the condition is not serious. It is usually only temporary. In normal development, specialized bone growth centers (called growth plates) change over time from cartilage to bone. The growth plates expand and unite. This is how bones grow in length and width. Bone growth centers are located throughout the body.
As the bones of the leg begin to grow longer, they sometimes grow at a faster pace than the Achilles tendon. The Achilles tendon is then too short. It begins to put tension on the back of the heel. When this happens in kids who are active in running and jumping sports, pain occurs where the Achilles tendon attaches to the heel.
Kids with tight hamstring and calf muscles seem to have a greater risk for the condition. The problem is compounded when they play sports on hard surfaces, such as playing soccer on hard outdoor fields. The constant impact can disrupt the bone growth centers in the back of the heel, causing inflammation and pain.
Sometimes, the passing of time may be all that is needed. It takes one to two years for the bone growth plates that make up the back of the heel to grow together and form one solid bone. At this point, pain and symptoms usually go away completely.
The doctor may prescribe anti-inflammatory medicine to help reduce pain and swelling. A small lift or pad placed under the sore heel may help, too. The lift angles the foot down slightly. This angle relaxes the Achilles tendon and reduces stress where the tendon attaches on the back of the heel. In severe cases, when other forms of treatment don't give relief, doctors may recommend a walking cast for six to 12 weeks. The goal is to stop the foot from moving so that inflammation and pain go away.
I read this information with my son and he felt better knowing the cause of his pain. When we got to the part about the walking cast, he eyes widened and he was ready to do whatever he needed to do. First of all, we went and got him a really good-fitting pair of supportive running shoes. He happened to be fitted by a man who specializes in fitting runners, and he was familiar with Achilles issues. He spent a lot of time with us, trying lots of different pairs of shoes until we found a pair with the right mechanics for his foot. Then he took the insole out of the shoe and cut some cardboard to fit in the heel area, put the insole back, then had my son try the shoe with the gel inserts. After all this, when the sticker shock for this pair of shoes was starting to make me sweat, he gave me a nice discount. I had all three boys with me there and he was pretty sure he'd be seeing us again.
The Aleve helps, the shoes with inserts help. And taping up his Achilles for the soccer games really helps too. My husband taped ankles for various sports when he was in college, so he is the Designated Taper (DT) now in our house. (For a good description of how to tape an Achilles, see http://www.sportsinjuryclinic.net/cybertherapist/back/achilles/tendinitis/taping.php)
The first time we taped him, he thought it worked great, but taking the tape off was very painful. He described it as "ripping my flesh off." So before we taped it for the next game, we all decided that shaving his leg was a good idea. I, being the most experienced at shaving legs, am now the Designated Leg Shaver (DLS) in the house.