When my son started coming off of the soccer field complaining about pain in his heels I just thought he had poor fitting cleats. Cleats do not have a tremendous amount of support in them to start with and playing in them 6 hours or more a week I figured could cause the pain. It wasn't until I was speaking with another parent at practice one night that I figured out that the pain could be caused by something else. After a trip to OrthoCarolina we found out that he has Sever's in his left heel. The initial diagnosis sounded much scarier than it actually was. A few weeks later we were back at OrthoCarolina with our other son who was having knee pain and he was diagnosed with Osgood-Schlatter, again much scarier than it sounds. After speaking with the PA, I was surprised at how common both of these are in children, not just athletes, but active children in general are at risk for both of these common childhood orthopedic issues. We spoke with Trish Moody CPNP, MSN at OrthoCarolina to get more information about both Osgood-Schlatters and Sever's Disease, to find out what they are, how to treat and when you should see a doctor.
What is Sever's?
Sever’s disease is an irritation of the growth plate in the calcaneus bone. It presents as pain in the heel.
What is Osgood-Schlatter?
Osgood-Schlatter disease is an irritation or inflammation of the growth plate in the top part of the tibia. It usually presents as a painful bump just below the knee.
Is there any way to prevent your child getting Sever's or Osgood-Schlatter?
There is no good way to completely prevent getting Sever’s or Osgood-Schlatter. We typically recommend a good stretching program in children as they grow. A good stretching program will hopefully prevent or at least minimize the symptoms of Sever’s or Osgood-Schlatter disease.
What age do you start to see Sever's and Osgood-Schlatter in children?
Typically, Sever’s presents in children ages 9 to 11. We certainly occasionally see children a bit younger or older than this. Osgood-Schlatter presents in a slightly older population around age 13 or 14.
How long will they have it?
The length of time children are symptomatic varies. We usually tell people the process may last 1 ½ to 2 years. This typically occurs intermittently during that time frame and is typically not constant.
What parts of the body are most likely to be impacted?
Growth plates are the areas most susceptible to injuries in children. When children are active, they can develop overuse syndromes to the growth plates. The calcaneus and proximal tibia are the most common but we also can see it in the pelvis, wrist, elbow and shoulder.
Do some kids end up with both?
Yes. Some children are susceptible to growth plate inflammation. I frequently see children with Sever’s disease who come back a few years later with Osgood-Schlatter disease.
How do you know if your child has Sever's or Osgood-Schlatter?
If your child has Sever’s disease, they typically complain of pain in his/her heel. Usually, only one foot is involved but occasionally both heels hurt. With Osgood-Schlatter, children will complain of pain around the front of their knee. This can easily be confused with patellar-tendinitis so an evaluation in our office is important for a proper diagnosis.
Is Sever's different then growing pains?
“Growing pains” is a diagnosis we make when we have ruled out other causes for children to have pain. Some young children complain of pain in their shin or thigh that we consider “growing pains”. In theory, Sever’s and Osgood are both types of “growing pains”, as they occur because children are growing.
What can parents do for their kids with Sever's or Osgood-Schlatter?
When a child receives a diagnosis of Sever’s or Osgood-Schlatter disease in our office, we spend considerable time educating the family about the condition as well as management techniques. We have educational handouts on both of these conditions that we provide as well as therapy programs that are recommended for both of these conditions.
How important is proper shoe fitting to help kids with Sever's?
It is important that all children wear shoes that fit their foot correctly. When children have Sever’s disease, we typically recommend they use heel cups in their shoes to minimize symptoms.
When should parents bring their kids to OrthoCarolina to see you if they are worried about Sever's or Osgood-Schlatter?
We always recommend that children be seen in our office to confirm these diagnoses. Many times the treatment is conservative but we have all of the education and therapy recommendations to provide families. Occasionally, there could be other causes of their pain so it is important to have an appropriate evaluation and diagnosis.
Does stretching help? What are some stretches you recommend for children who have Sever's or Osgood-Schlatter?
YES! Stretching is the most important thing in managing both of these conditions. We recommend Achilles stretching exercises for Sever’s disease. Quadriceps and hamstring stretching and strengthening is important in managing Osgood-Schlatter. When patients come to our office for evaluation, we provide these exercises and can initiate the proper physical therapy referral if necessary.
Bottom line, don't ignore these pains. They are very real and there are things that can be done to help give your child relief. Starting with OrthoCarolina is the best first step, because the staff there is specially trained to work with children and orthopedic issues you will safe yourself a lot of time and aggravation by going right to the experts in the field. Trish Moody worked with SCMK on this information, to make an appointment with Trish or one of the other specialist at OrthoCarolina Pediatric Clinic you can call the appointment line at 704-323-2543. Trish did let us know that work-in appointments may be available for injuries and OrthoCarolina also has several Urgent Care offices. For additional information on Sever's and Osgood-Schlatter's you can visit the Patient Education section of OrthoCarolina's website
About Trish Moody CPNP,MSN
Undergraduate UNC
Graduate degree Duke University
Joined OrthoCarolina in 2003
