severs disease

[Panda-girl's Mom]

I was reading about this in the coaches forum. My daughter was diagnosised with this in the fall. When I took her to the sports medicine doctor he said she can tumble all she wants that it won.t cause any damage but in the coaches section I saw something about a modified training plan. She wears a heel cup, some days she is fine other days she is limping out of the gym. Her level 6 floor routine is giving her difficulty along with vault and jumping on the beam. I tried to get her to take the vitamen oscon but she hates the taste. I think her one coach who had this understands but as far as I know they are not doing anything different in her training. It is very frustrating because I think the pain of it was contributing to her wanting to quit but now that she made up her mind to continue I think she is trying to ignore the pain but I can tell when she is hurting because of the way she is walking. I usually give her motrin if she says it is bad. Any other ideas she is only 10 so I do not think she is going to stop growing soon.

 

[3rd_time_around]

My dd dealth with this since level 8. She is finally outgrowing it, I hope. There's not much you can do except quit. The boots they put some girls in won't help, and even if they rest for a month, once they start back it will hurt again. It is very common in kids age 9-12, esp gymnasts or like athletes. Some of the things we did for my dd was ALWAYS wear tie-up shoes with gel heel inserts or heel cups. Get the ones from 10-0 that she can slide on or tape on. Motrin helps with the pain. Ice and massage at home. And a chiropractor. Our chiro would adjust her heel, foot, and ankle, and showed us how to tape for support while tumbling--this was the best thing we did. Another girl at the gym had a severe case, and I recommended chiropractic treatment, and she stopped having the pain. Her mom was so happy she almost cried. Severs is discouraging, but with perseverance and patience she can make it. My dd is 14, and just yesterday noticed that her heels don't hurt any more. YAY!

 

[BlairBob]

You need to take her off the hard pounding and let her ankle grow and heal. No tumbling or running on hard surfaces. Sucks, but it's the best in the long run. Taping and chiropractics make be useful as trigger point therapy and another physical therapy.

 

[taximom]

My daughter also has a Sever's dignosis, which then led to an Achille's tendonitis diagnosis. She always wears her running shoes Asics with the pronation support and inserts in them. Lots of ice, physio, massage and chiropractor. She modifies her training if it's hurting, no tumbling and vaulting. She has a home stretching routine to follow and looks forward to when she is done growing!

 

[3rd_time_around]

You need to take her off the hard pounding and let her ankle grow and heal. No tumbling or running on hard surfaces. Sucks, but it's the best in the long run. Taping and chiropractics make be useful as trigger point therapy and another physical therapy.

Its the heel, right, not the ankle. And the chiropractor helps a lot, its not just trigger point pressure. They actually do adjustments to the foot, ankle, knee that all are connected. When everything is straightened out and where it belongs, there is less pain and the body functions properly. Don't poo-poo chiropractic till you try it. It really does work and helps not only my dd be a better gymnast, but other girls in our gym as well. It's not just another physical therapy, it is aligning the body into it's proper position for optimum performance and results. I highly recommend it for all gymnasts, and esp for severs disease. A good chiropractor will know the proper treatment.

 

[bogwoppit]

The problem with chiropractors is that not all of them are well qualified to do what they are doing. Therefore sorting out a good one from the bad ones is not easy. Glad yours is great, but not every one has the same results.

I recommend going to a sports therapist to be assessed, they can treat and give stretching and strengthening exercises to help speed recovery. However severs does not go away quickly and only time will actually heal it. Soft tumbling and landings with reduced running are needed. Training through pain is a big no no.

 

[Deleted member D3987]

there's nothing to put back in to place or align with calcaneal epophysitis. it's the growth plates!

 

[Crystalflipz]

Caileigh had this her first year at L6 and it sucked! She would tape the Dr Scholls heel gel inserts to her foot and then use the Tuli Heel cup over it - did this with both feet for over a year. Mid-way through her first year at L6 she dropped back to L5 and finished the season there which really made a big difference. There is much less pounding at L5 on floor and beam, plus she was comfortable with the skills at that level so rather than working with pain and frustration she actually had a good positive end to her season. She kept using the heel cups for a couple years after that, but giving her that 6-7 months of respite made a huge difference. As long as a gymnast has not competed in a state meet at her current level, she can drop back a level - better to do that in my mind than be so frustrated with the pain that they quit.

 

[AGM78910]

My previous post on this topic seems to have disappeared! Will try again.
My DD has had several bouts of Severs in her heels and Osgood-Schlatters in her knees between ages 9 to 12. We took her to a Sports Medicine Physician who prescribed stretching and exercises for her. She never had to miss practice or reduce her hours. We did a lot of the stretches at home and she recovered very quickly.
The doctor recommended no heel cups, shoes, or taping because that increases the time that it takes to get over it. Doctor also did not recommend supplements such as Oscon because they were unproven. In other words, there is no good double-blind medical research on it. However, you can't discount the placebo effect.
In short, the only thing that really helped my kid was the stretching and it had to be done daily.

 

[gym law mom]

As parents you want to help them feel better, but in reality this is just a nasty phase of growing and what kids and parents don't want to do is what works best---lay off the pounding/running. Motrin will help for a short while, so will icing and taping. In the end this just helps the kids feel better for a little while. As Dunno said there is nothing to align---chiros are not going to help and paying them is usually all out of pocket. Having your child wear shoes with gel heel pads can help since most kids have to walk around most of the day before getting to the gym. No sandals or flip flops.

 

[gymjoy]

Dd is dealing with Severs - and we are happy about it (LOL).

Why? because the original diagnoses was stress fracture in her heel. We have good reason not to trust the doctors in our HMO insurance coverage. This is not the first time they have told dd something was broken when it was not broken, not is she the only gymnast to have this happen to her in our area. We agreed to the boot while we sought a second opinion outside of our insurance. (No, we were not seeking a diagnoses we liked, just double checking because of the track record of our insurance system) The second opinion came from a well respected ortho who has worked with gymnast before. He, and a colleague, diagnosed severs.

DD has had bouts of Severs before, this one just came on fast and strong. She is now stretching and icing, stretching and icing. She works hard on the quality of her skills to avoid doing too many repetitions. Her coaches have dealt with this many times, and will let dd back off when needed. She is wearing a heel cup for now, but she does not like it, so it won't last long. She is very, very happy to be training again and to be able to compete this season (which we thought might not happen if the stress fracture diagnoses was confirmed). So, Hurray, it's Severs!!

 

[bpatient]

Dd is dealing with Severs - and we are happy about it (LOL). Why? because the original diagnoses was stress fracture in her heel.

The physicians may actually be in agreement, as the results of repetitive microtrauma and overuse can be labeled in various ways, including, as here, as stress fractures:

Sever's Injury: A Stress Fracture of the Immature Calcaneal Metaphysis. Journal of Pediatric Orthopedics. 24(5):488-492, September/October 2004.Ogden
Magnetic resonance imaging (MRI) in children with a presumptive diagnosis of Sever's apophysitis and with continuing pain after conservative treatment demonstrated bone bruising within the trabecular bone of the metaphyseal region adjacent to the calcaneal apophysis. Limited portions of the apophyseal secondary ossification center showed similar increased signal changes. MRI studies following treatment with immobilization showed subsidence or disappearance of the metaphyseal but not any apophyseal signal changes commensurate with improvement in symptoms. Accordingly, the disorder commonly referred to as Sever's "apophysitis" may be a metaphyseal trabecular stress fracture, similar to the toddler's calcaneal stress fracture that has minimal or no involvement of the apophyseal ossification center, and thus should not be referred to as an apophysitis. Rather, it appears to be an overuse injury causing microinjury within the developing metaphyseal "equivalent" trabecular bone that has not completely adapted to the changing biologic (biomechanical) requirements of the growing, athletically active child.

 

[gymjoy]

Thanks rbw - and I think I will have to look up a few of those words in there to make sure I understood what I think they are saying. Dd is being careful with her training, and I am keeping a close watch on her to make certain that she is not trying to fool any of us.

 

[Panda-girl's Mom]

Thanks for the replies. It sounds like maybe limiting her tumbling is agreed on from most of the responses but I am still not sure why the ortho doctor we saw said she could tumble all she wants. I did tell my daughter to tell her coaches when it hurts and they did allow her to ice tonight. Her coach did show her stretching exercises, I am going to be more vilgilent and make her do them on a more regular basis. As for the level 6 tumbling I agree it does seem harder on her heels but for now she seems to be happy with the 3 other events other than floor. I do not think moving her back to 5 would make her feel any better. We are halfway through the season so I am going to just take it day to day. If she is able to compete floor at the next couple of meets and qualifys to states great if she can't because it is just to difficult with her heels it will not be the end of the world. I just want her to be happy going to the gym which she has in the past week and do what she can, it does not sound like this condition is going away quickly. I will continue to remind her when it hurts at the gym tell the coach take a break and ice. So far they have been really supportive by letting her scratch floor at her last meet so I am hoping this continues or else I will have to renforce my wishes to them.