WAG Sever's Disease

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Coach
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I know there's lots of posts here on Sever's, but I'd like to get some opinions from different perspectives (parents, coaches, and gymnasts) on the topic.
How do you deal with Sever's Disease and training?

We took my daughter to the pediatric orthopedic doctor a couple of weeks ago. She was diagnosed with Sever's. the doctor gave her some heel cups to put in her shoes, told us that she could continue training as long as she could tolerate the pain, but we would need to ice bath her feet and calves 3 times a day. We followed those directions, plus, when dd was at gym, we would have her doing a modified workout to be careful not to aggravate her heels.
We went back to the doctor 1 week later for a recheck. She told him that her heels were still bothering her. The doctor consulted with the pediatric surgeon and them decided that dd should go into a short leg cast on BOTH feet for 10 days to ensure that she wasn't walking or putting any pressure on her heels. We were able to talk him into just one foot in a cast for the time being...but when we go back if the uncasted heel is still flared up, he will cast that one too.
Anyway, has anyone else had to have their kid's foot casted for sever's? We have had kids in our gym with severs, but never a kid who needed a cast. The dr just basically told us that it woul be the fastest way to get the swelling down and back to regular workouts.

Any input from anyone??
 
My 8 yr DD, has Sever's and so do a few other girls at our gym. My DD did not need the boot (yet) and has two bad flare ups in a year. The girls who had the boot (only one foot), seemed to go through their flare-up and get over it in about two weeks. I can tell you what I have done to not wear the boot and keep pain down:
Ibuprofen in the am and before gym (during flare-ups) or every 6-8 hours. Ice heels before and right after gym (during flare-ups). Sneakers during floor and vault during flare ups (they hate this, but it helps). Achilles tendon stretches: go on toes on stairs and push up and hang heels down, about 15 times, before gym, and after. Cheetahs Tuli Heel Cups all year when no flare ups. No wearing flip flops at all, and sneakers with a raised heel helps (like running kinds).
We hate Severs! Not only is it awful having your DD in pain, but my DD has trouble even doing the basics when it happens (and we have had two bad meets that she suffered through).
I hope your DD's flare up recedes quickly. Severs eventually resolves, unfortunately, when they stop growing. Good luck!
 
DD has been through mild Sever's as have a couple of her teammates, and one of my son's teammates was booted. I know it's a bummer, but she probably is going to have to rest it for a little while. Keep in mind that even 2-3 weeks off is not that long in the grand scheme of things.

In DD's case, her first flare was last year, and she was on modified workout for two weeks and missed a meet. When she started having problems this year, we went straight for the heel cups immediately. She's been in one now for about two months and reports that all she's feeling now is a little bit of pain when in big eleve on beam. Her coach's rule for Sever's flares is "no landings that make a noise." That seems to work pretty well, and I second Amber's suggestions except that I'd be wary about administering ibuprofen before gym, as it could mask warning pain both from Sever's and other surfacing problems.

The only good thing about Sever's is that if a girl or boy goes through this off and on for a while, s/he tends to get a lot better on bars/rings/pommel!
 
FIrst time my DD dealt with severs, we booted her. The coaches thought we were crazy but she healed up very fast and came back 100%. Meanwhile, other unbooted gymmies were still coping with pain weeks later. Since then, when she gets a flair up we do the ice and stretching and cheetas for a week. If its not better in a week, we throw the boot back on (though we havent really had too). The key has been for DD to tell us the instant she feels any pain in her heel and we begin therapy immediately.

Good luck!
 
We've only had one child booted for Sever's that I know of. It helped but the next time it flared up, the family just did heel cups. Wearing sneakers and not flip flops makes a big difference in number of flare ups! My dd used to love wearing clogs to school but now wears sneakers every day. We've used heel cups both in shoes and during gym when flare ups occur. Ibuprofin taken religiously for 2 weeks also has knocked it out. Older dd is now dealing with Sever's cousin - Osgood. The fun never ends!
 
In addition to the above we massaged the foot and calf. There are a couple of good videos on youtube. Basically massage the foot & calf and stretch the calf while you are massaging. The pressure has to be very light over the achilles and heal and a little deeper pressure over calf and arch of the foot. It seemed to make a significant difference and my daughter loved the idea of having her own massage therapist (me) :)
 
My daughter had Sever's for a good portion of 2 years and we treated it with icing, and the cheetah heel cups, modified workouts etc but it wasn't until she broke her foot and ended up in a cast for 8 weeks that it went away...she came out of the cast, tried one front tuck on beam (felt a tinge and never did another one!!) , and has never (knoock on wood) had the issue again...and that was 6 years ago. In retrospect my daughter said the heel cups really didn't do anything but the casting was what definitely helped...
 
Sounds like most of the kids with severs went into a boot and not a cast... Actually, Dd's doctor had a nurse fit dd for a boot, but in the middle of the fitting came back and said "I think I want this little one in a cast and not a boot. We need to put an anchor on this girl...slow her way down..." He then went on to say that he really wanted to cast both feet at the same time. This idea totally freaked me out. I know that LOTS of people deal with way worse than having a kid in a cast on both feet, but with our current situation I just really didn't want to have to do that.

My other question is this: when this flare up has passed or healed or whatever, will there be more flare ups? Will they be constant? And if there are more flare ups how long do I wait to call the dr? It's a really tough call with my dd. She has a really high pain tolerance and doesn't always let us know that she's in pain. For instance, it was when I noticed her doing bhs and just landing on her toes, or walking on her toes and not touching her heels when she walked that I discovered her heel pain. We've had to get specific with her and she has to answer "are you in pain - yes or no?" There is no "a little bit" or "kind of"....so it's hard for me to know when to call the dr and when to treat at home....

Any thoughts?
 
Unfortunately, Severs can reoccur everytime they grow. In addition, your daughter may have similar flare ups in other joints. So far, my daughter has had Severs (several times) plus flare ups in her wrists and knees (the worst). So far she's avoided a boot but the knees were bad and almost drove her to it. She injured another part of her body and is on limited workouts which is giving her knees a rest.

We've gone to the doctor each time but the x-rays/MRI's are clear except for the inflammation. So we keep ice packs ready in the freezer and begin icing/massage/stretching as soon as she starts experiencing pain. She wears heel cups pretty much permanently.

I get those same responses.:) So I've learned that "some" means "a lot" and when she says "yes" she's really in pain. Unfortunately, they seem to have really high pain tolerance levels and are extremely motivated to go to practice. I simply hand her an ice pack when I see her walking at all strangely.
 
You do need to emphasize that working out in pain can result in injuries that could lead to a lot worse than a few weeks without tumbling.
 
We have had good results with Oscon supplement and stretching and ice cups when necessary. Also, don't wear flip flops or Ugg boots if possible, only tennis shoes with good support.
 
this is such a simple condition to manage. it's a shame that there are programs that don't know how to manage this. geesh...:)
 
this is such a simple condition to manage. it's a shame that there are programs that don't know how to manage this. geesh...:)

Dunno - what's your position on managing severs? Your recommendation on managing a flare up in the stage where the kid walks with a limp or on toes because of heel pain? How do you manage a kid who has a mild flare up or beginning heel pain? What do you do to prevent inflammation from occurring in the first place??

My kid's cast came off today. Her inflammation is down, but not entirely...her pain wasn't as bad after just a week of rest. They put her in a boot and told us that she should lay off of all activity for 8 weeks. Any additional flare ups after that, we restrict activity and use the boot. If it's bad I'm told to bring her in to go into a hard cast....

I've read about sever's online. Most of the recommendations are ice, NSAIDs, stretches, heel cups, x brace, cheetah cup ankle supports, massage, air boot....and complete rest.
 
Larry is the best. and i mean the best. when the kid is hurting we lay off. when they are not they go like gangbusters and get as many turns within reason that they can. so then, on again and off again until they make it thru that growth spurt. it's that simple. and they spend time on the trampoline. trampoline does not exacerbate the problem.:)
 
Larry is the best. and i mean the best. when the kid is hurting we lay off. when they are not they go like gangbusters and get as many turns within reason that they can. so then, on again and off again until they make it thru that growth spurt. it's that simple. and they spend time on the trampoline. trampoline does not exacerbate the problem.:)

I really have nothing to add to this except that Dunno and Larry (love, love, love him) gave this same advice to my daughter about five years ago. She had Severs in badly in both heels. My daughter followed the plan and *magically* about 17 months later the heels were fine and she was living happily ever after. Well maybe not totally happily forever because while the heels are fine she is now following Larry's elbow advice! So basically what I'm saying is trust the heel whisperers ;)
 
Larry is the best. and i mean the best. when the kid is hurting we lay off. when they are not they go like gangbusters and get as many turns within reason that they can. so then, on again and off again until they make it thru that growth spurt. it's that simple. and they spend time on the trampoline. trampoline does not exacerbate the problem.:)

So this will calm down and we might get some time with no severs at all? Them next growth spurt we might have severs again?

In the video, Dr Larry talks about if it's bad severs, about 4 weeks in a boot can do the trick. In your experience, Dunno (and anyone else please feel free to give me your experience), if the kid goes into a boot for severs and after 2 weeks is pain free, do you leave them in the boot for 4 weeks or let them resume training since they are "pain free" or have limited, tolerable pain?
 
When I was 12 I had very bad severs... No running jumping for 4 weeks- only pit runs. They went away and they have nagged me a little if I increase tumbling a lot or grew... But I just iced and stretched and luckily haven't grown a lot recently
 

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