Parents Yet another sever's question

[kaloss]

Was this you ped or a sport med dr? Usually you will need an order for PT, but your reg pedi may order it for you w/o a visit. If you've been calling your pedi, then call a sport med doc (I bet you have one since you got a boot...boots seem to be the answer to everything right now...sigh)
For severe's it is an agpophysitis where the achilles hit the calcaneus (heel bone) and irritated the growth plate there. Here is a picture (I hope this works)
Link Removed

So there are a couple important pieces for this and most people use some combo of these
1. rest
2. achilles stretching (her toe walking is a huge indicator that there is trouble here)
3. antiinflammatory (ice, nasals)
4. heel lift/heel cup/nxtmile inserts in shoes/cheetah cups...never barefoot in a tennis shoe with insert (and not something from the Dr. sholl's stand in the store) unless in bed or shower. as improvement happens with stretching/PT then can move to gym in her shoe/insert, then to tennis shoes all the time except gym...
These kids show avoid flip flops, ugg boots, barefoot, sperrey's, ballet flats etc...really for a few years until they are closer to post pubertal height.
5. PT is essential for stretching the achilles if "conservative" measures don't work or if you are "in season" or even just a competitive athlete PT should really be involved from the beginning. You can imagine that all the rest in the world isn't going to fix the tight achilles that is pulling on the apophyseal plate...


Not sure if this helps, but I'd get a sport med doc (a new one) and PT asap. They may also X-ray which is not normally needed to diagnose this, but since after weeks and weeks in a boot she is no better and is having pains that awaken her. (night pain is rarely a good sign) - there is a (benign) tumor called osteoid osteoma that is typically in the tibia (lower leg bone) that is known for night pain/night awakening. (it would show on X-ray) I worry a little that her pain is as proximal as her knee at times.

This was a pediatric sports med attached to our children's hospital. I will continue to call but also see what our options are for a standard sports med dr, since we aren't able to get in touch with the peds dr. Thank you for your input!

 

[gymjunkie]

And make sure that you even need the referral. The PT facility we use tells me that most of their clients do not have referrals. I generally send kids to PT first if it's a common gymnastics ailment such as severs. If it doesn't resolve with PT, then they see the sports med doctor for further investigation.