Parents Sever’s Stories

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cogymmom2dd

Proud Parent
Has anyone had a kiddo with Sever’s disease? If so, I’m curious as to what your treatment path was.
DD1 has recently been complaining of pain to the heel/arch area of her foot. She says it is worse when she points her toes and has been pronating her foot when she walks.
There is no known injury, she said it started hurting when she did a double back into the pit at practice one day, but didn’t land weird and landed into a mat on top of foam.
I have a background in the medical field, although mainly caring for the adult/geriatric population for the most part but have some knowledge on peds and the first thing that came to mind was Sever’s disease. She fits the picture perfectly. She is going through a growth spurt- has grown about 4 inches since summer, is 11 years old L7, so is doing high impact tumbling repetitively. She also has a very muscular body frame where she is small but strong and fast but not necessarily flexible and her flexibility has been compromised by this past growth spurt, and I have heard that gymnasts with these body types are more prone to sever’s. On assessment, she has a positive squeeze test, which is the basic diagnostic test for this.
I have a great relationship with our pediatrician and she put a referral in for a pediatric sports medicine specialist who has on-site PT’s, and a few that specialize in gymnasts, but we are still waiting on insurance to approve everything.
In the meantime, she is taking it easy at practice, focusing on stretching and no high impact tumbling. (Even if she gets official restricts from a specialist, we will continue to talk her to practice to at still keep her engaged). We ordered an X-brace for her to try along with some inserts for her everyday shoes and have started icing her heel and taking ibuprofen as needed.
My question is: What should we expect from the sports medicine people? My pediatrician said it’s always a case by case basis but I was curious to hear first hand experiences from parents who have gone through this. I want to be able to be prepared for the news of needing to sit out, be in a boot for a few weeks, etc. Stories of simple at home therapy with ice, braces, ibuprofen, and stretching are also welcome.
 
My kid did better with a cheetah cup over the X-brace but wore the X-brace for meets since it is less obtrusive. But cheetah cup every practice. Lots of gentle stretching. Tumbled mostly on rod or tumble track. We also bought Oscon which really seemed to help...
 
We dealt with it for years. It comes and goes aggravated by growth. We had no success with sports medicine doctors. After years we finally tried a sports podiatrist who was able to help. Being bare foot is not a friend which as you know is impossible to avoid in gymnastics. They learn to live with it and cut down on repetitions when it flares up.

My daughter had great success with using the x-brace. They wear out kinda fast but was the only thing that helped. Once her foot stopped growing it has mostly gone away.
 
Cheetah cups every practice. No bare feet. Ice every night (we just had a couple of disposable water bottles that got put in the freezer every night.
We statrted this after a growth spurt 3 years ago. She iced every night for 2 years. Still wears cheetah cups. No longer any pain unless she doesn't wear the cheetahs at gym practice, or if bare foot and active for hours (beach, water park, etc).
 
We dealt with it through a growth spurt. Lots of rest. The three months of gym shutdown did wonders for her severs. She also wore cheetah cups and it helped tremendously with the pain.
 
We did lots of stretching (multiple times per day), iced it, x-braces for the gym and inserts for her tennis shoes. If she had pain at the gym then she skipped vault that day as well as tumbling if needed. We caught it right away (older brother had it during soccer so I recognized the signs quickly) so hers was mild and went away with the above treatment. She still stretches daily, wears x-braces and inserts and that has seemed to keep the flare ups away. She tried cheetah cups but has very small feet and found them to be overwhelming.
 
My daughter has this and we didn’t really follow doctors recommendations with any consistency for about a month after her diagnosis. Once we decided to get serious with the doctors recommendations, we saw a difference. Ibuprofen twice a day for two weeks, icing twice a day for two weeks, no bare feet around the house, no tumbling, vault, or dismounting for two weeks, cheetah cup or xbrace at practice, and stretching exercises everyday. This made a big difference for her. She still has some minimal pain but she has been able to return to full practice and is no longer complaining about it on a daily basis. We are continuing everything to keep her pain away except now we only do ibuprofen before practice and not everyday.
 
She really liked both of these and found them helpful. She used the cushioning sleeve around the house instead of being in bare feet.
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I hope it's okay if I post here as I'm not a parent but this is my personal experience. I developed Sever's when I was 12 before my level 8 season, I actually remember the exact thing I was doing when I first felt the pain (BHS in a row on the floor for conditioning). I bought heel cups that I had taped on during practice (like the cheetah cups) and wore in my shoes outside of practice. Ice, ibuprofen, and wouldn't tumble or vault if the pain was more than mild-moderate. The doctor didn't give me a boot or give me any additional special instructions other than to keep off of it if it hurt too badly. The pain would go through flare ups every so often and they only lasted somewhere from 12-18 months in total. I developed them during a very small growth spurt and they didn't come back when I was a teenager and had my larger growth spurts (although I did later have other issues like shin splints). Overall it was a blip in my time as a gymnast. I hope this helps and that you are able to find something that works for your DD. Best of luck!
 
Thanks for all of the recommendations!
Our insurance approved the referral today and the clinic actually called me this afternoon and asked if we could come in the next hour because they had a last minute cancellation. My diagnosis was correct. It’s sever’s.
They did xrays and there weren’t any abnormalities or areas of concern. Sounds like we started down the right path at home early on with the typical treatment. I did end up getting her cheetah cups and the x brace to try. The doctor also said no more bare feet unless you are at practice and only wear shoes with laces to help support the foot... so we had to go out and buy a new pair of shoes because she is in a Vans and Crocs phase and already outgrew the pair of tennis shoes I bought her this fall.
As of now, no specific limitations unless she is above a 5 on the pain scale, then no tumbling or punching the springboard for vault- she can do tumbl track for her tumbling instead. I do know that the gym has a mini tramp that I’ve seen them use before with vault that might be less impact for her, but she’s doing Yurchenkos and I’m not sure it’s a effective way to train using one. I’ve updated her coaches and they will modify her workouts as needed.
 
We got heel cups to put in her tennis shoes when she was at school and that has made a big difference as well. I think Tulis (nots ure on spelling) is what we got. Also lots of calf massages-- her calves are super tight and that exacerbates the issue so if you can stretch and get the calves loose it will help alot. There are some great videos online about massage for severs that you as a parent can easily replicate. Ice after practice is a biggie and we went to PT to get exercises and stretches to help with preventative measures. Once she stopped growing it went away but it seems to be coming back now with some fun foot tendonitis to boot cause evidently she has an extra bone in her foot right at the attachment site of an important tendon. Ah the joys of gymnastics!
 

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