Shoe Tips To Prevent Sever’s Disease

Sever’s disease causes heel pain in youth athletes known as calcaneal apophysitis. It is the most common cause of heel pain in children between the ages of eight and sixteen.

Sever's Disease results from stress placed on the growth plate of the heel bone. Girls are most commonly affected between the ages of 8-10 and boys between the ages of 10-12. Excessive amounts of running or jumping with the heel in a “negative position” — common in soccer —causes inflammation to the growth plate of the heel bone, which causes pain and limits a young soccer player's ability. The muscles, tendons and ligaments are not growing as fast as the bone growth plate is fusing, which can lead to the growth plate giving way and becoming inflamed in the presence of tight muscles.

A common preventable cause of Sever’s disease is a worn-down cleated shoe where the heel sits low, forming the negative heel. A cleated shoe in general places the foot in a position where the heel is lower than the toes (it's similar to walking uphill). The heel increases motion in all planes leading to local inflammation. A solution is to place heel lifts — either 1/8- or ¼-inch — in the cleats to put the foot and ankle at better mechanical advantage. Stretching the calf, Achilles and foot muscles is also key in prevention of heel pain and growth plate disturbance.

Cleats generally don't have the same shock absorbency as running shoes. With children playing soccer year-round, often three or more times a week, purchasing a stable, low heel-cleat count, shock-absorbing shoe is well worth it. Cleats focus pressure on the heel, causing stress that can result in inflammation and pain over time.

Keep in mind the common foot injury of Sever’s disease, and promote daily foot stretching and strengthening exercises along with shock-absorbing, heel-lifted cleats.

Colleen Schwartz, DPM is the owner of Pilates on Spring, Pleasanton, Calif., mother of Pleasanton Rage and Ballistic soccer players and member of the American Academy for Podiatric Sports Medicine, email: