London physio - Severs Disease.

[xanthe]

Does anyone have recommendations for a London based (south-east or central preferably) physio who is knowledgeable about feet, dance and young children?

 

I'm looking for one for one main reason and one secondary.

 

Secondary reason is that I'd quite like an overall idea of DD's potential in terms of flexibility and turnout - I wouldn't book a physio appointment just for that, but if I can satisfy some curiosity and also tuck away the info in case it's useful later then killing two birds with one stone would be great.

 

The primary reason is due to Severs Disease - this is a nasty that tends to hit between the ages of 9 and 11 and causes inflammation in the growth plates in the heel. It's horribly hereditary and both my father and I had it very severely as children (2/3 of my siblings had it mildly) - I spent over 2 years in plaster casts (6 weeks in, 4 weeks out) and it's miserable... feels as if you have a piece of broken glass stuck in your foot with every step and I had to give up all sport for nearly 3 years.

 

My father, me and DD all have the same shape legs and feet - disproportionately long legs and very high arches and insteps, which leads me to suspect that DD will have a similar muscle, bone, ligament and tendon structure and therefore have a high chance of developing Severs.

 

Nowadays the treatment is generally rest, ice and insoles, but there are people who are using physio to work on lengthening the hamstrings and various other bits to stop the pulling and inflammation. DD is nearly 8, so if there are exercises out there that could help we'd have some time to get cracking.

 

I spoke to our GP about seeing a physio and she basically said to bring DD in if she develops the pain and they will do a referral then. Did not understand at all that I would like to pre-empt her ever developing the wretched thing.

 

So I've decided it would be best if I take DD to see someone myself but finding the right physio is hard. DD does have BUPA, but not sure that this would be something they would cover.

Would also love to know if anyone else has successfully used physio to treat/prevent Severs.

[Science in Dance]

Hello there, I believe I might be able to help. 

 

I am a Dance Scientist and Dance Rehab specialist based in the North West. I have come across similar conditions and symptoms in young children before and although a Doctor would advise complete rest until the pain subsides the symptoms can normally subside within a few months with the correct exercise prescription and therapy.

 

A high street physio would be able to advise on Severs, however, in relation to Dance and how much Dance your daughter can do alongside assessing and strengthening her turn out you are right to seek a specialist in the field. 

 

If you would like to contact me directly with regards to exercise prescription for your daughter and to organise a session to help her on her way please feel free to contact me. Or I would be happy to put you in touch with reputable Dance Physios in your area if I am too far away.

 

I currently work as an Independent Sport/Dance Scientist and S&C coach working with a Vocational Ballet School and Ballet companies but you can reach me on my personal business email: shapedynamix@gmail.com

 

All the Best and Happy to help.

[MumToTu]

Hi Xanthe, my dd suffered from this a year ago thankfully over school holidays, but she suffered a lot of pain, at the time she was training a lot of gymnastics 16 hours maybe more a week before a comp and her coach had to pulled her out and advised a prompt visit to a physio as she couldnt run withou bring it in agony! Let alone land off a vault etc. Of course she never told me, as she hated missing practise!

 

We asked our GP to refer her through our BUPA, who found a her a local physio. As we needed one we could travel to easily, but couldn't have helped with dancer assessment though....! but BUPA did say we could pick our own and are totally flexible. She advised total rest, strictly no ballet or gymnastics, thankfully it was over Christmas anyway and was given twice weekly follow up physio assessments/treatments for 3 weeks until 100 percent recovered. Ankle stretches to do 3 times a day, standing on stairs lifting her heels up and down etc. Plus she advised temporarily wearing heel cups in her shoes. You can buy them online. And as quickly as it came on it went. She had stiff Achilles for a while after I noticed she couldn't do the yoga position downward dog etc at all!, which made me laugh as my Achilles are really loose! And she's really simular to me in her legs.

 

Complete rest off activities was the hardest thing for my dd..! She was mortified at the idea. Though thankfully, it sounds like a mild case compared to your Xanthe! She was never in a cast thankfully !

As quickly as it comes on it goes thankfully, it seems to coincide with her pre teen growth spurt and she too has really longs legs, high arches and very slim delicate ankles, so no muscle fat around the Achilles the physio said to protect it. She's also tall, so growth spurts are probably bigger too, so the ligaments can get really stretched as they need time to catch up.

 

Wishing your dd a speedy recovery. My dd really enjoyed the fuss of having a physio, and keep begging me to let her have a sports massages, which she didn't need she just liked the idea..!

Edited February 26, 2017 by Snowflake

[xanthe]

Thank you so much for the replies here and all the PMs - all very helpful and I will be contacting the various physios people have recommended and suggested.

 

Snowflake - so sorry to hear about your DD and I'm glad it has settled down for her - hopefully that's it done (sometimes it can reoccur with another growth spurt). Interesting that she has the high arches and long legs - it does seem to be a factor.

 

So far my DD is fine - it was me who had it so badly as a child. I remember the misery of both the pain and the ban on sports for those two years and I wouldn't wish it on anyone! Given how identical she is to me in terms of her feet and legs, I'm hoping to prevent if possible or at least potentially minimise the problem - the idea of enforcing complete rest in DD fills me with horror!

[MumToTu]

Thank you Xanthe, I don't if this may help, but physio told her to maintain her stretches especially during growth spurts, I am sure very safe for anyone to do, they were :-

 

Stand on a stair with just her heels off the end and slowly raise her heel below stair level up and down 3 times a day if possible. Also, to stand facing a wall with one foot against it and put her other foot flat on the floor behind it as far as she can and feel a gentle stretch.

 

The physio treatments are fabulous! So, great help is out there if does strike.

 

Hoping your dd stays pain free ! Truely painful, horrible condition for an active child! I have read high impact sports can be a real trigger, so I keep her away from hockey and cross country racing clubs etc at school now. I am sure a good physio will sort her out a preventative plan and fingers crossed! Well done for being one step ahead...!

[Jan McNulty]

Hello there, I believe I might be able to help. 

 

 

 

 

Hello DSMDoc and welcome to the Forum!

[Peanut68]

I think this is a really interesting topic & actually part of a broader issue of how best to prevent injuries/conditions in dancers.....

I always suffered from shin splints & only advice I impart to DD is to always bend knees, don't walk straight legged, cushion landings etc etc bugt am sure there are probably physiological reasons behind my  regularly getting this pain (with or without dancing) which Physio could identify in me & others & offer preventative strategies....I know voc schools all offer physio & do checks pre offering places  & regularly after too but actually I think more of this sort of thing would be beneficial - I think schools are increasingly offering targeted exercises & supervised use of weights/bands etc all of which is great for our DC's longterm health & wellbeing. More please!!

[drdance]

I conduct injury prevention screenings for young dancers and can advise on 'pre-habilitation' exercises etc. please PM me if you're interested.

[Science in Dance]

Hello DSMDoc and welcome to the Forum!

 

Thank you 

[Science in Dance]

I think this is a really interesting topic & actually part of a broader issue of how best to prevent injuries/conditions in dancers.....

I always suffered from shin splints & only advice I impart to DD is to always bend knees, don't walk straight legged, cushion landings etc etc bugt am sure there are probably physiological reasons behind my  regularly getting this pain (with or without dancing) which Physio could identify in me & others & offer preventative strategies....I know voc schools all offer physio & do checks pre offering places  & regularly after too but actually I think more of this sort of thing would be beneficial - I think schools are increasingly offering targeted exercises & supervised use of weights/bands etc all of which is great for our DC's longterm health & wellbeing. More please!!

Dance Science and Strength and Conditioning for performance enhancement and injury prevention is gaining a lot of traction now especially at vocational level. 

It has also gained promising inclusion in what I call "grass roots" dancing as it is particularly important to start this movement and education pattern from early years onwards to aid. Long Term Dancer Development. 

LTAD (Long term athlete development) describes many protocols and strategies that have been around in Sport for many years. 

 

The best thing is that young Dancers seem to absolutely love it. 

 

Recently had a lovely young dancer grinning from ear to ear following some basic muscle activation work as she should safely and easily find positions and perform movements with relative ease.

[alison]

I thought that since this thread discusses Severs Disease I would also link to this post:

 

[Peanut68]

I am going to repeat here a comment I have made in another topic:-

Word of advice....take care when seeing professionals who have little/no experience of dancers/sportspeople. We saw a podiatrist when heel pain struck who basically said straight off don't expect to ever dance again. The fear & panic that a massive life change may be enforced onto a child was awful & incredibly tactless & inept I thought. however, a change of daily footwear (away from dreadful flatter than flat Velcro fastened shoes), paying more attention to stance, leg alignment & reminding not to roll all helped improve the situation swiftly - as did just settling into the new height/body shape after growth spurt. If we need advice/help/physio again I would certainly seek out a dance/sports specific professional & steer away from those whom mostly see Johnny Average.