May 2015

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Click on image to Download the complete supplement in its original form PDF

Editor Message


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


Obese children develop knee malalignment as they mature

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By Emily Delzell

Lower-body focus could help youth baseball player arms

Studies link hip, shoulder function – Kids grow up thinking that throwing a baseball hard is all about strength in the arm and shoulder, but new evidence suggests that muscle strength and range of motion in the hip affect shoulder function during throwing in youth baseball players.

By Chris Klingenberg

Kinematics identify subgroups of kids with CP and equinovarus

Treatment planning could benefit – Chicago researchers have identified clinically relevant subgroups based on foot and ankle kinematics in children with equinovarus secondary to hemiplegic cerebral palsy (CP) that could help improve treatment planning and clinical outcomes.

By Barbara Boughton


Hip disorders in children with Down syndrome

As hip arthritis becomes a growing concern in adults with Down syndrome, clinicians are also becoming more attuned to hip issues in children with DS, in hopes that early intervention in the pediatric population will help reduce the risk of disability later on.

By Shalmali Pal

Sever disease: Intervene early to relieve symptoms

Once pain and inflammation have been addressed, clinicians can implement interventions—including orthotic devices, stretch­ing, and strengthening—to address the biomechanical factors that are believed to contribute to heel pain and other symptoms in this population.

By Erin Boutwell