For Parents Sever's and casting????

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munchkin3

Proud Parent
Jun 6, 2008
2,102
DS may have legs casted.....Sever's....anyone gone through this with their gymmie??
 
D

Dallas Gym Mom

My 13 year old went through several episodes of Severs. She just had physical therapy which consisted of lots of heel stretching and she continued working out. Her coaches talked to her doctor and modified her workouts to minimize the pain. It took a few months of therapy but she is fine now.
I took her to a doctor who is a Sports Medicine physician who specializes in treating gymnasts.
 

bogwoppit

Gold Membership
Feb 26, 2007
16,879
My oldest had quite a few years of severs. She went to a psorts injury specialist for treatment. She was limited severly in vaulting, tumbling and running and she did twice daily stretching and icing. This was followed up by strengthening when the pain had subsided.

She took Oscon as a supplement towards the end of the two years, the pain seemed to dissapear at the same time, coincidence? Who knows.

It seems to be well in the past now, but dealing with it took a lot of time and perseverance on her part and a lot of money on my part.
 
T

taximom

My DD has recently dealt with Sever's as well. She is 11 and had a huge growth spurt this Spring. We saw a Sports Doctor at a sports clinic and did Physiotherapy and had x-rays to rule out stress fractures. My DD also wore Tuli's Cheetah's heel cups while training and was sentenced to running shoes any other time. Lots of ice and stretching as mentioned and thankfully she is currently pain free.
We expect reoccurences with each growth spurt but at least we know what to do now.
The specialist we saw mentioned casting but said he's only had to do it once and it was because the child refused to even slow down. He said to ensure proper nutrition, make sure DD gets enough protein to repair her muscles from training.
Best of luck to you and your DD :)
 

gym law mom

Proud Parent
Dec 23, 2006
2,525
Went through Sever's with my gymmie. She still has some occasional discomfort, but the worst seemed to be about age 11. The PT she's worked with in the past gave her some stretches for the Achilles, but did not feel any therapy really helps. Again like the others we did the ice, ibuprofen, shoes on at all times(except gym), gel heel inserts and tumbled only on tumble trak and cut back on vault.

Casting is a last ditch effort to resolve the problem and usually only done when all treatment has failed or the child is not compliant with the restrictions. If your ds needs casting then there will be a little therapy once the cast comes off since the ankle will be stiff and need some strengthening.
 
C

cathiann

Beth just got diagnosed with Sever's. She's icing three times a day, has stretches to do and has to wear heel lifts in her shoes--oh and can't wear flip flops anymore. She hasn't restricted anything at the gym, but does stop when it hurts. Oddly enough it doesn't really hurt her on vault--just floor.
 

gym law mom

Proud Parent
Dec 23, 2006
2,525
Beth just got diagnosed with Sever's. She's icing three times a day, has stretches to do and has to wear heel lifts in her shoes--oh and can't wear flip flops anymore. She hasn't restricted anything at the gym, but does stop when it hurts. Oddly enough it doesn't really hurt her on vault--just floor.

Boy, my gymmie just suffered on vault with the heel pain although I think some of that was not admitting it hurt until the pain got to the point where it just bothered her to walk around school. I asked her what hurt more---running or hurdling onto the springboard and she said the running. She even changed the way she ran(unknown to us and coach didn't seem to notice) for her L7 state meet. Ran more up on her toes to avoid putting all that pressure on her heels.

One thing we found that helped was letting her soak her feet in lukewarm water every night. She still does it---I think more out of habit while she uses the pumice on her hands. A coach at the gym was going through the heel pain with her older dd and they had tried everything without much relief. One night her dh said why not warm instead of cold(he's a gym coach too) and within a week she was getting some relief.
 
C

cathiann

One thing we found that helped was letting her soak her feet in lukewarm water every night. She still does it---I think more out of habit while she uses the pumice on her hands. A coach at the gym was going through the heel pain with her older dd and they had tried everything without much relief. One night her dh said why not warm instead of cold(he's a gym coach too) and within a week she was getting some relief.

Really?? I'll have to have Beth try that. The cold helps, but not a ton. Thanks!
 
Oct 10, 2008
111
Our daughter had a HORRIBLE case of Severs. We took her to what I believe is the only place in the US that provides heel cups that are custom molded and stay on their feet DURING practice. They casted her feet and made these hard cups that stay on with velcro straps. They cost a pretty penny but she has had ZERO pain for over 6 mths now. We SWEAR by them now.
 
B

bpatient

Rest to recover from overuse

The specialist we saw mentioned casting but said he's only had to do it once and it was because the child refused to even slow down.

Taking time off or even slowing down seems to be difficult for many gymnasts!

Here are a few comments related to "slowing down" and casting:

  1. First, a review of Severs disease suggests that it is an overuse injury and not a conventional apophysitis. "[Based on MRI studies,] Sever's “apophysitisâ€￾'… appears to be an overuse injury causing microinjury within the developing ... bone that has not completely adapted to the changing biologic (biomechanical) requirements of the growing, athletically active child." [Ogden JA;et al. Sever's injury: a stress fracture of the immature calcaneal metaphysis. J Pediatr Orthop. 2004 Sep-Oct;24(5):488-92]
  2. If you think of it as an overuse injury, it's clear that reducing activity ("slowing down" or taking a few weeks off rather than, say, just icing and continuing to train) is a crucial aspect of therapy.
The suggestions that follow (including the comment on casting) are from "Clinical features and management of heel pain in the young athlete", a recent article from UpToDate, a continually-updated on-line resource for physicians.

  1. Treatment is aimed at decreasing the inflammation and stress placed on the apophysis. Decreasing the volume and intensity of activity will help to decrease the pain. Stretching the gastrocnemius-soleus complex, the use of a heel cup or 1/4-inch heel lift, and use of proper footwear will help to decrease the traction force on the apophysis.
  2. Daily icing for twenty minutes, even after symptoms have begun to improve, will help to decrease inflammation. Although NSAIDs may be helpful for pain control during early management, they should not be used before exercise or to increase the amount of activity that the athlete can tolerate.
  3. For the compliant patient whose symptoms fail to improve within four to eight weeks, short-term (three to four weeks) short-leg casting may help to resolve painful symptoms related to stress associated bone changes. Physical therapy and slow progressive return to activity are important to recovery.

 

munchkin3

Proud Parent
Jun 6, 2008
2,102
Well.....second opinion and it is Sever's but they gave us a more realistic approach...
Icing, stretching, and rest if possible...Advil before practice...
DS likes the Cheetah's...he wears socks over them! He thinks they are for girls LOL!
Casting is only for SEVERE cases and DS is mild to moderate so he says.....I ask him to rate the pain 1-10 after practice....

DS is also inherently TIGHT TIGHT TIGHT in the calf muscles so I think we will have to learn to manage this for a long time since he is only 9 and doing 10hrs. in the gym....(not much compared to the young ladies!)

I guess STRETCHING will be our new passtime:eek:

Thanks all
 

bogwoppit

Gold Membership
Feb 26, 2007
16,879
Well.....second opinion and it is Sever's but they gave us a more realistic approach...
Icing, stretching, and rest if possible...Advil before practice...
DS likes the Cheetah's...he wears socks over them! He thinks they are for girls LOL!
Casting is only for SEVERE cases and DS is mild to moderate so he says.....I ask him to rate the pain 1-10 after practice....

DS is also inherently TIGHT TIGHT TIGHT in the calf muscles so I think we will have to learn to manage this for a long time since he is only 9 and doing 10hrs. in the gym....(not much compared to the young ladies!)

I guess STRETCHING will be our new passtime:eek:

Thanks all

This is my 12 year olds life, stretch, stretch and stretch again. She began with knee pain at 9 and quickly moved to ankle pain. She is very tight from her hips down to her toes. She has to stretch daily and I know that it has slowed her progression in gym as she has had to take many months off gym in order to be pain free.

Fortunately we had cheetahs, which do help quite a bit. I feel that continuing gym is a good thing as she has to stretch and she might not is she didn't participate.

Not easy, but it is managable.

Glad to hear of the 2nd opinion, much better option than casting.
 
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