Parents Severe Sever's?

[Elle Kaye]

Hi all,

I'm new, as you may see from my post count .
My dd is 8yo (9 in June) and is finishing up Level 3. She has one meet this weekend and then states in around a month. After that there are a few more weeks and she'll be in summer training. During the year she's been doing 9 hours(3 hrs, 3 days a week) but summer will be 25 (5 hours, 5 days). She loves gym and she loves learning new things so she's happy for the end of the season and the start of summer.

But...

In the Fall she had a flare up of heel pain, which I figured out was Sever's. We got through it with x-brace, Cheetah cups, good shoes, and stretching. Yay. Then we got lazy about it and she wasn't even wearing her x-brace during practice for months. They started working front handsprings and it came back, worse than ever in her right heel. During the worst time she was limping throughout the day. She took two weeks off and we did a lot of icing, stretching, massage. It got somewhat better but it's still bothering her and it's been going on for a month. When she wakes up she limps around until her shoes are on and then she doesn't limp anymore. Right now we're doing 2-3 20 minute ice baths a day, 2 massages a day, and stretching. She's sometimes doing full gym practices and sometimes not doing any tumbling/landing stuff. We went to the doctor who said it's just Sever's and to keep on with what we're doing and rest as needed. I wonder if dd might also have some combination of bursitis and/or Achilles tendonitis too based on where and how it hurts her. She does not seem to be going through a growth spurt either in her feet or elsewhere. She's very small for her age and if anything I think she's falling even further behind her friends in both height and foot size.

So, I guess I have two questions:
1. Have you managed to get a child through heel pain of this severity with something like the protocol we are doing? Did it require time off completely from gym and how long? I am inclined to see if we can get through states and then take some time off if needed so that she can handle the increase in hours in the summer. If she stays as she is now I see no way she can do even 3 hours of gym a day, let alone 5.

2. Is there anything I'm missing in terms of dealing with this?

thanks.

 

[Popcorn]

I took ds to a foot doctor for his pain. He had pain for months and we kept trying rest, ice, better and better shoes, etc., but it always came back. The foot specialist made him specialized orthotics which and now there is no pain.

I'm not saying it's always that simple, but I do think that the right specialist makes all the difference!

Edit to add: He wears shoes with the orthotics at gym when he is conditioning and the coach has been great about reminding him to wear the shoes whenever it is safe (not doing landing events, etc.).

 

[SurpriseGymMom]

Not to discount your DDs pain, but honestly that sounds like pretty normal Severs to me... When it's bad, DD limps around too. It's nothing dangerous and it sounds as if you're doing the right things to help her. When DDs was at its worst (severs combined with pulling something in that general area causing even more inflammation and pain) she simply stayed away from the things that were most painful, in her case tumbling and vault. The "take off" push was worse than landings for my DD, and vault was the worst for that (she's a L7). She did everything else though and as soon as the inflammation from the additional injury was lessened, she resumed full activity. We are way less diligent about massaging and icing now, we should keep it up but it seems to be in more of a down phase right now.

 

[SurpriseGymMom]

For some reason it wouldn't let me keep writing....
I wanted to add that something like this is something ALL gymnasts deal with sooner or later. Yes, they should listen to their body and let you know if there's pain, but they also need to figure out what constitutes REAL pain and injury vs what they need to learn to push through. Severs, OS and a few other things ARE painful but not harmful in and of themselves, so it's something that they need to deal with during training. There are aids to help and you're doing all of that. I think in DDs training group there may be one or two girls WITHOUT some sort of brace/aid right now, ranging from OG knee support bands to wrist supports to cheetah cups to all out braces and even one back support.... DD is currently sporting cheetah cup for her severs, KT taping for a sprained muscle around her knee, wrist taping for sprained wrist extenders and just a couple of weeks ago her other ankle was all taped up because she lightly sprained it. Just normal average stuff that hurts and is inconvenient but nothing serious.

I would make sure you keep doing your regimen. Make sure she wears supportive shoes outside gym (no flip flops etc). Take her to a chiro/PT if you can, that has helped DD a lot. Tell her coaches so they can modify her workouts instead of having her not go to practice.
Best of luck, hope the flare is over soon!

 

[Elle Kaye]

thanks. SurpriseGymMom, thanks for saying it sounds like normal Sever's. I definitely have some confusion about how much she should be encouraged to push through pain and/or if there's a possibility of more damage (a snapped tendon? a fractured heel growth plate?) if she does. She's not generally a kid who complains about stuff but this is the first thing she's had that's more than discomfort and I think she's also reading my confusion and putting it all together and feeling confused herself about how much pain she should push through. The doctor we went to was a podiatrist and wasn't so helpful - wanted her in a soft cast or a boot for two weeks and then not doing anything that aggravated it. Maybe a PT would be good. Right now dd tells me that some of the stretches we are doing (just standard ones like dropping the heel down to stretch the calf and achilles) hurt her as much as doing a round off back handspring (which - aside from vault - is what causes her most pain in the gym these days) so she's also resistant to doing the stretches... Maybe having an outside party like a PT would be helpful so it's not just the entrenched parent-child dynamic.

 

[B&M's mom]

I'm going to take the opposite tack on this. While it may be normal Sever's, your best bet is to get it checked out. Sever's can potentially lead to worse problems. My DD has had severe pain in her heels for months. She's been limping around and unable to train or compete floor or vault because of the pain. We've been been to the doctors but she didn't want to rest because she was hoping to be able to make it to Nationals. At State, she landed short in warm ups on floor and came off in tears. She apparently cracked in or near her growth plate which the doctor believes is due to old Severs. (My daughter's feet have stopped growing so its not a new bout of Severs). I wouldn't wish the months of pain that she went through on anyone.

I've learned the hard way that normal soreness or temporary pain is fine and can be dealt with but if the pain continues, get it checked!

 

[Elle Kaye]

Is there anything you wish you had done in terms of checking it out that you didn't do? We went to a podiatrist, she took x-rays, said it's Sever's and suggested a boot for two weeks. It's been about 3 weeks since then with diminishment of pain relative to the worst days (the limping all day days) but certainly not complete elimination. I guess I feel like I'd like it to be checked out again but don't expect any different outcome, you know? Sorry about your dd's heel; that is definitely the kind of thing I am afraid of.

 

[2littlegymmiesmom]

We went through a very similar situation with my DD. She had her first flare up during Level 3 and it wasn't too bad. Just a couple of weeks of rest and modified practice. The second flare up this fall while she was training Xcel gold was very bad. Doctor was worried about it turning into a stress fracture so she ended up in a boot and on crutches for 4 weeks and then an additional week after the boot came off with no tumbling. We did stretching exercises, ice etc and she wears a cheetah cup for practice and supportive sneakers with gel inserts. So far we have managed to keep from having any more major flare ups. She now knows that at the very first sign of pain she needs to back off on the tumbling and vaulting until the pain lessens. The sports medicine doctor said that prevention is the best thing because once the pain starts there is really nothing you can do but ride it out and modify work outs as needed. Just be careful that if the pain is that bad it might be best to see a sports medicine Doctor just to rule out anything else. Good luck and Hope she heals quickly.

 

[Half-Pint]

My gymnast has never dealt with severs but my ballet dancer has. Here is what helped her:

1. Wearing gel heel cups in her tennis shoes (only shoes she was allowed to wear)
2. Never walking around barefoot, even at home
3. Nightly calf massages
4. Epsom salt baths and/or natural calm magnesium supplement

Stretching during a flare-up would always make it worse. I discovered that the tight calf muscles were the real culprit and started massaging nightly, completely avoiding the Achilles' tendon and working until the muscles had loosened up. If we stayed on top of those tight calves she eas able to keep dancing.

 

[Taurus]

Just my 2 sense (see what I did there? - take your dd's foot in your hand and look at the arches - do they look flat/ collapsed? Truthfully I wouldn't have known to look but my girl's coach told me to get hers checked out/ and lo, she did have collapsed arched (from being barefoot most of the time as a small child) - took her to podiatrist (confirmed early sever's) and got $200 insets which she wears in her shoes everywhere but gym (we have sworn off flats for now) - and it has made a big difference in pain & in pigeon-toeing / I would try to find a podiatrist that is at least familiar w/ those kinds of inserts or one who sees atheletes - plus you can see a PT who can work on strength training her muscles to keep them properly stretched - but it's expensive & rarely covered by insurance at their age unless it is considered a major deformity - my girl is 8 too

 

[Elle Kaye]

Thought I would update that just as I was getting SO frustrated that there seemed to be no end in sight for this flare, I think it's abating! I don't know if it's what we were doing - lots of ice and massage plus x-brace, Cheetah cup, etc - or it was just destined to end anyway, but I can tell there is less limping and dd is complaining less. I did add two things into our regimen - one is that I had dd wear this ridiculous plantar fasciitis sock while sleeping that I got for me when I was having a pf flare (called the Strassberg sock); the other is that we found this anti-inflammatory lotion that we used while massaging her leg - it's got arnica in it and it's called Penetrex. So there we have it - now we have to work on getting her the rest of the way better AND not slacking off when she's not having pain...

 

[Gymanna]

Good to hear it is improving slightly for your daughter. We are in EXACTLY the same situation here with a similar age and level gymnast. My daughter is still limping constantly so reading your update gives me a bit of hope. It is such a hard one as so many people are saying she should just learn how to deal with it but they don't see the aftermath and the waking up at night and the constant limping. So we have gone for a few weeks total rest to see if this helps. Did your daughter actually have a boot in the end, did it help?

 

[Elle Kaye]

We did not do the boot even though the podiatrist recommended it. I just felt like we hadn't given it everything at that point - I brought her in when it turned from limping in the morning to limping all day long and being painful enough that she could not participate in basically any activities that involved being on her feet, but that had happened sort of suddenly (after a meet) and we hadn't been doing too much to try to improve things before that. I knew from here and elsewhere that the boot is kind of a last resort and I also was a little worried that dd would hurt something else b/c the boot would have made her higher on one side than the other. So, we held off and have managed to see a lot of improvement without that sort of immobilization - at this point she's running around to play now and the last few days I have not noticed her limping even in the morning.

 

[Gymanna]

How's the sever's going Elle Kay???

 

[motigymnasticsmom]

DD has severs with the second bout, she had Achilles problems and problems with the muscle on the bottom of foot. We did all of the regiment what you are doing, but a PT suggested a tennis ball. DD rolled her feet on it whenever she was sitting and watching TV. It worked like magic. She broke her heel bone last year also and we did the same regiment plus tennis ball as severs. She was ok after one month.

 

[Elle Kaye]

How's the sever's going Elle Kay???

She's doing well! It really did ease up a few weeks back - she complained 1x last week but I think that was more in her head than in her foot to be honest. We have states this weekend so hopefully all will stay well for that and beyond - into the summer when the hours go up!