How come my child’s heel pain isn’t getting better ….
“He had heel pain last year and now it’s back. They have NO idea what it is. They did an x-ray and it’s not Severs. The physio massaged his calves and it helped for a few weeks but it’s not better. It’s almost been 6 months. We had to halve how much sport he does now and he hates it. As soon as he starts running or playing a game, it comes on. He describes a tight feeling when he walks too”
Very honestly, these were the exact words that came from a frustrated and concerned mum, paired with an equally frustrated 13 year old boy, just before lunchtime today. This family traveled across the city to see us, which is not uncommon but it must be frustrating.
The tragedy in these words is that they’re NOT uncommon. At least a few times a week I hear grumblings from frustrated parents – and they most definitely have a right to be frustrated! – because they’ve seen various practitioners without a real diagnosis and just when something has been suspected, imaging has gone and ruled it out and we’re back at square one. Or are we?
The matter of the fact is: People make mistakes. Practitioners make mistakes. Radiographers make mistakes. We’re human! It’s going to happen.
I feel like I could host a conference discussing the amount of times I’ve been handed an xray telling me that there is nothing wrong with my patient that currently sits in front of me in AGONIZING pain!
If it doesn’t sound right, you better believe that it’s not. Let me emphasis: pain does NOT happen for no reason, and no amount of negative radio-graphs is going to magically fix your very real pain.
So then, WHY does this happen?
There can be a variety of reasons, and I’m going to give you the very real uncensored version that other practitioners may get annoyed at me for.
• Referrers can order the wrong TYPE of imagine study. If you’ve damaged a muscle, ligament, tendon or any soft tissue, your x-ray will show you are perfectly fine! Yep, go over there and sit your torn Achilles tendon down because you’re fine to go run that marathon. (Please DONT we are kidding)
• Radiographers are very HUMAN and can miss things. Some are likely to have seen more of a certain condition, or be more familiar with an area of the body, and so some may pick up or recognise things that others miss. And you can’t blame them – the body is composed of an extraordinary amount of bone and soft tissue and any expectation for every single person to be a scholarly expert on every single part is drastically unrealistic.
• Things CHANGE over time. Your imaging from a few months ago is a picture of what is happening in your foot a few months ago. Since that time, some tissues may have gotten better, some tissues may have gotten worse, and some ones may now be damaged that weren’t before!
- There is NOTHING wrong with wanting a second opinion and getting a referral for another ultrasound or X-ray
- There is NOTHING wrong with re-imaging if you feel that your injury has changed. And if you’re having pain but you’re being told there’s nothing wrong, you have EVERY right to be frustrated!
- You SHOULD get a second opinion! or a third even if you are not getting the answers you need.
- There is increasing evidence that we need to look past radiology reports and look at clinical symptoms
So what do you do next?
Your child should not have to play sport in pain, we can happily tell you that we work with kids to get them back to happy healthy and active every day. Our team will work with your child to develop a detailed care plan, this of course after a thorough assessment of their run + walk patterns; including video analysis. we will examine foot wear and make recommendation and look at the damaged soft tissue and assess what is the best way to rehabilitate this back to health! They may require a soft pliable orthotic for inside their shoes to wear while playing (just like our patients that are international level athletes!)
One of the delightful things about treating kids is seeing them return smiling and back to playing the sport they love!
And for all those wondering.. Yes our little champion from this morning did have Severs 😉
A Step Ahead Foot + Ankle care
Penrith, St Marys and soon to come to a suburb near you!