LER: Pediatrics – May 2015
Don’t wait for them to outgrow it
One of the challenges of parenting is determining when the best course of action is to do nothing and wait for a child to outgrow a phase he or she is going through. And this may be a perfectly reasonable approach to a child’s invention of an imaginary friend or a teen’s obsession with Goth fashion. But lower extremity pain in children—even pain that a child is likely to outgrow—shouldn’t be ignored.
The heel pain associated with calcaneal apophysitis, or Sever disease, is a case in point. Yes, most children will eventually outgrow this type of pain, but that can take years. With treatment, on the other hand, symptoms can be resolved in three to six weeks (see “Sever disease: Intervene early to relieve symptoms,” page 15). I’d be willing to bet that most active children would rather take a few weeks off from soccer and return pain-free than to play through pain for multiple years. And I’d also be willing to bet that most parents would make the same choice.
As an added advantage, treating a child for calcaneal apophysitis is also an opportunity to give that child a strong biomechanical foundation that could decrease his or her risk of injury in the future and improve athletic performance in the meantime. Stretching, strengthening, and orthotic management of altered gait mechanics are all interventions that can give children significant benefits, even those who don’t have heel pain.
Many parents will recognize this. But some will still come to the clinic hoping to be told their child simply has “growing pains” that will magically go away without any type of intervention. It’s a nice thought, but the truth is that even pain a child is likely to outgrow is still pain that should be managed.
Jordana Bieze Foster, Editor
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