This topic seems somewhat timely given these particular injuries are normally load related.
As discussed in my previous blog about Load Management, the last 6 months have played havoc with people’s Acute Chronic Workload Ratio and children/adolescents are no exception.
The conditions I will be discussing are usually related to a big spike in activity which has been the case this year with most sporting organisations eager to recommence their seasons. These spikes will be somewhat amplified in young athletes who participate in multiple sports or who are already specialising in their chosen sport which can mean numerous training sessions/games per week.
Sever’s Disease
What?
An irritation of the insertion of the Achilles into the calcaneus. This differs from adult Achilles tendinopathy due to the immaturity of the adolescent skeleton which means it affects the actively remodelling trabecular metaphyseal bone.
How?
As mentioned previously, it is usually due to the area’s inability to deal with an increase in activity (particularly activity that uses that area eg running or jumping sports).
When?
More common in boys and usually between the ages of 10-15 compared with girls which is usually between the ages of 8-13.
How does it resolve?
Usually self resolves with time (6-24 months) however the reason it’s best to seek treatment/advice is due to the pain that accompanies the condition which can affect sports performance and most importantly day to day activities.
What is the treatment?
The main focus of treatment is to reduce pain levels. This can be done in a few different ways including:
- Manual therapy (eg muscle massage)
- Heel raises for footwear to offload the tendon
- Taping to offload the tendon
- Exercises to strengthen key areas
- Implementation of load management strategies (eg RPE scale)
- Advice regarding recovery (eg icing)
The main takeaways about the condition are:
- The adolescent will grow out of it
- It can still be quite painful however so there should be a focus on pain relief
- Load management with guidance from a physiotherapist can allow the continued participation in sport without compromising day to day function
If you would like your injury reviewed by one of our physiotherapists, then don’t hesitate to book an appointment. All of our physiotherapists specialise in sport and have had extensive experience with adolescent athletes.