Parents Heel pain(severs apophysitis ) with increased training hours

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Hello all, first post here!

Just took my young gymnast(6yo) to the sports medicine doc with heel pain. She recently increased her training hours from 4 to 9 since joining the gyms level 3 team. I was told she is experiencing “severs apophysitis” or basically pain in her growth plate area underneath her heel and shes been advised to ice after training sessions, wear a heel cup whenever possible, and do some home exercises, but was told there is NO guarantee that her pain will get better.
I understand injuries come with the territory, but I’m doing my best to prevent them with a healthy diet, good sleep and no additional workouts outside of the gym.
Has anyones gymnast experienced this before and if so, how long? What ways did you help your gymnast recover? Thanks!
 
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Has anyones gymnast experienced this before and if so, how long? What ways did you help your gymnast recover? Thanks!

Yes... don't have time to respond right now... will respond later with some tips. My daughter dealt with severs for years... it was manageable (at times).
 
 
OK... trying out my new search and tag feature. Here are some threads from the past about severs...

 
My daughter had it for almost two years. The pain use to just come and go, we took her to the doctor and the basically told us when she’s done growing the pain will stop. Cheetah cups and exercise is all I can really recommend.
 
basically told us when she’s done growing the pain will stop

This is exactly what we were told as well.

@Alongforthegymride I will say that we did have tremendous results with massage... icing... correct shoes... workout modification... ibuprofen... and these...

Link Removed

As a coach I do not recommend the Tulis Cheetah's as the waffle heel cup provide almost no cushion and they slip on some athletes when performing the roundoff of a Yurchenko vault (this becomes extremely dangerous). The problem with the AchilloTrains is that they only come in larger sizes. We actually learned of these from another local club that had all ditched the Cheetah's when their high level athletes started slipping in them.

They are currently $124 each foot. If an athlete fits in these... I 100% recommend them. The $250 is nothing for the relief that they provide. Even with these... it will still take all of the above to even get to 30% of the normal impact numbers.

I am looking for a massage / stretching video now... the old one seems to be gone.
 
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Not a medical professional but as a wearer of AchilloTrains I recommend them and suggest carefully following the measurements provided on the website even if it’s tedious to take them. They do provide a lot of relief, especially to get past the phase of constant, acute pain.

A lot of pediatricians default to Severs as an explanation for heel pain, but it is important to assess calf tightness and hip weakness, too. If these aren’t addressed it won’t be a matter of “growing out of” Severs. Weak outer glutes can be the reason for Achilles and heel pain and calf tightness; definitely get a referral to a PT from a doctor if possible.
 
This one is more of what my wife would do with my daughter. I have it starting at the point I am talking about around 5 minutes. In the video she flexing the foot pretty hard... I would start much softer than that... but the massage while flexing the foot (stretching) was key for my daughter.



My daughter dealt with severs for about 5 years... then bam... totally gone when she was around 15 years old.
 
Not a medical professional but as a wearer of AchilloTrains I recommend them and suggest carefully following the measurements provided on the website even if it’s tedious to take them. They do provide a lot of relief, especially to get past the phase of constant, acute pain.

Lot's of good stuff here... the AchilloTrains are very hard to size correctly. Don't just pull them on as hard as you can either... they will rip and you will be out $124. They come with a sleeve thing to help slide them on.

A lot of pediatricians default to Severs as an explanation for heel pain, but it is important to assess calf tightness and hip weakness, too. If these aren’t addressed it won’t be a matter of “growing out of” Severs. Weak outer glutes can be the reason for Achilles and heel pain and calf tightness; definitely get a referral to a PT from a doctor if possible.

I agree with this also... make sure the diagnosis is backed up by an orthopedic sports doctor.

Here are some videos about this product (which is probably going to be to big for a 6 year old)...



 
In defense of the Tulis Cheetah's... some gymnasts use just fine... some tape them on so they don't slide. A 6 year old will probably need to start with them as their feet are most likely going to be too small for the AchilloTrains.

The overall issue with the Tulis Cheetah's is that they are made of neoprene... so they cause the foot to sweat and then they slip when the heal is planted.

Amazon product ASIN B000MT3G6O
They also do not stabilize the achilles tendon at all... they are just a heel cup sewn to a sock.
 
Hello all, first post here!

Just took my young gymnast(6yo) to the sports medicine doc with heel pain. She recently increased her training hours from 4 to 9 since joining the gyms level 3 team. I was told she is experiencing “severs apophysitis” or basically pain in her growth plate area underneath her heel and shes been advised to ice after training sessions, wear a heel cup whenever possible, and do some home exercises, but was told there is NO guarantee that her pain will get better.
I understand injuries come with the territory, but I’m doing my best to prevent them with a healthy diet, good sleep and no additional workouts outside of the gym.
Has anyones gymnast experienced this before and if so, how long? What ways did you help your gymnast recover?

there isn’t a whole lot of high quality research surrounding this topic and as another person kind of already mentioned, “severs” has basically become synonymous for heel pain. I do not have a ton of coaching experience under my belt to provide great insight on my athletes experiences but I will say my athletes who have been told they have this report a basic physical exam being done and nothing more for diagnoses, which makes me question the point of slapping a “disease” diagnoses to something that could just be a result of increasing training hours or load too quickly.

There are a lot of different things that can be done to modulate the experience of pain, none being all that special. Massage, ice, stretching, etc can temporarily decrease pain but it seems that most people skip to passive treatments to deal with the symptoms and ignore why they might have come on in the first place. Pain is complex and every person is different, but a 6 year old going from 4-9 hours is a big jump and im assuming the heel saw a spike in stress that the body was unable to adapt too. I am not saying a 6 year old cant train this long, thats a whole other conversation, but the body cant just make massive jumps like this without some sort of ramp up over time.

Kindof a tough thing to manage as a parent, ultimately the coach in this situation will play the biggest role with influencing the heel pain. If they just tumble the kids to death for 9 hours straight theres no amount of massage, stretching, or exercise you can do to combat poor load management. I’d find a good PT (good luck!), but it seems the general approach to overuse injuries (assuming its not actually a growth plate issue) is to calm the area down, which could just be avoiding whatever is causing the pain to spike for a bit, and then build it back up to prepare for specific demands required by the sport.
 
My daughter started with Sever’s around the same age. We tired rest, ice, ibuprofen, and Cheetah cups. None of those worked. I finally got her into a PT and once she started doing the exercises in combination with the other things I mentioned, she finally started to get some relief. It still flares up from time to time but now she gets on top of the exercises right away and gets relief fairly quickly.
 
Massaging my kiddos calf and dealing with calf tightness was probably one of the bigger helps during flare ups. I will say the Cheetacups are alright but my kiddo switched the the xbrace and said it helped better and since its not this big neoprene thing you don't have the odor issues you have with a more traditional brace.

Now if anyone can help with foot pain for Accessory Navicular Syndrome which causes her Posterior Tibial Tendon to hurt please let me know cause her podiatrist said well it will probably hurt till she has foot surgery to remove the bone (which she has in both feet by the way) As soon as one pain goes away a new pain begins :(
 
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Here is a great write up on Severs...


Kindof a tough thing to manage as a parent, ultimately the coach in this situation will play the biggest role with influencing the heel pain. If they just tumble the kids to death for 9 hours straight theres no amount of massage, stretching, or exercise you can do to combat poor load management.

I would agree with the load management... but disagree with that is always on the coach. When a coach is fairly used to Severs and at a manageable point with it with the athlete... pain can still easily spike due to things that are fully out of control of the gymnastics coach. These things include... what they are doing at gym class... playing at home or recess... wearing poor shoes... wearing a heavy back pack around school.

The one thing to remember is that Severs is a very simple thing... many times the only way to manage it is to eliminate as much impact as possible while addressing any other issues that are causing it. While walking typically doesn't bring Severs on... if it is flared... walking can aggravate it or make it worse.
 
We have the highest rate in heel pain at our club with athletes that do gymnastics and basketball at the same time. That's just from my observations. Typically the heel pain starts almost immediately upon basketball beginning. Both of these sports are extremely high impact on the lower body.
 
DD had a similar issue. She was originally diagnosed with severs at around 9. However we later found out that it was Plantar Fascia issues/Plantar Fasciitis. We changed the shoes she was wearing and eventually the pain went away, we just have to be cautious of how much walking she does in a day and what shoes she's wearing. Not sure if this will help, but they are somewhat similar conditions, so.
 
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Oh I also highly recommend getting GOOD sneakers (not cheap or cool sneakers and definitely not VANS!!) and buying a good insole support for those sneakers. As @JBS said what they do at school definitely impacts heel pain. Big running PE days would cause big foot pain flare ups. Also we used to do under armor sneakers cause they were inexpensive but we saw pain improvement when we moved her to nice Nike running shoes with a insole support.

Also monitor how much time they spend barefoot. We have hardwood floors and walking around barefoot all day on those didnt help, flip flops in the summer were the worst! they spend so much time barefoot at gym its really important their feet are supported as much as possible all the time outside of gym. I would invest in good flip flops for the summer with arch supports. Oofos are what her podiatrist recommended and they made a huge difference in the summer time. If you find them on sale they are a decent price but definitely worth the investment. We always saw an increase in pain in the summer due to flip flops and barefoot time.
 

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