SalemNews.com, Salem, MA

Lifestyle

August 1, 2008

Server's syndrome is a result of child's growth spurt

There may be a bit of literal truth when you say your kids are growing up too fast. Sever's syndrome (SS) is a condition where the bones of the lower leg and foot grow at a rate that is faster than the surrounding ligaments and tendons. This results in shortened, tight tendons that become inflamed and irritated with normal everyday activity.

The onset of Sever's syndrome is insidious. It is slow and progressive and almost always goes unnoticed until your child discovers he or she is unable to walk without a painful limp. It usually appears between the ages of 5 and 13, when children's growth spurts are more dramatic. Classically, Sever's syndrome affects only one side of the body. Although rare, it is possible to have bilateral symptoms, so children presenting with pain on one side must have their other foot inspected thoroughly to rule out the potential for acquiring it.

The Achilles tendon is the primary structure involved with SS. It is the thickest tendon in the body. It begins at the base of the lower leg and bridges the calf and heel. When the bones attaching on either side of the Achilles tendon grow too quickly, the endpoint of either side of the tendon will become inflamed. This irritation will cause pain, especially with movement. Subsequently, we see a decline in children's ability to function when exercising, and in severe cases their ability to walk.

Usually, about six months will pass between the child's first subjective of complaint of pain and when they reach me in the clinic. Because so many children complain of minor aches and pains that alleviate within a day or so, it is difficult to evaluate a problem as serious and draw a firm conclusion that it needs intervention. Therefore I understand why so much time passes before help is sought.

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