Soccer is a high intensity support that requires lots of running and jumping over a prolonged period of time. Some players, especially youth, may complain of heel pain, both on and off the field. In most situations, the cause of heel pain is an inflammatory condition known as Sever's disease.
Soccer
Soccer is particularly prone to heel pain injuries because of the nature of the playing field and of soccer footwear. Soccer fields range from natural grass and artificial turf to hard dirt and sand. Most players wear traditional soccer cleats for all of these surfaces. Cleats are only meant for natural grass and some deeper types of artificial turf in which the cleat sinks into the surface and the foot is supported by the grass or turf. On harder surfaces, a player's weight is focused on the hard points of the cleat and into the foot. Furthermore, soccer cleats are designed so that the toe is higher than the heel, which creates an unequal distribution of pressure on the heel.
Severs disease
Sever's disease is common in young soccer players anywhere from 8 to 18 years of age. It is an inflammation of the area around the heel bone. In young developing players, the growth plate located under the heel bone is under significant tension from the Achilles tendon and the soft cartilage that holds it to the heel. Excessive running or jumping, associated with soccer, can put increased stress on this fragile part of the foot, leading to inflammation, swelling, possible fractures and pain.
Symptoms and Treatment
The most common symptom from Sever's disease is pain and tenderness on the sides and bottom of the heel. Some players may also exhibit minor swelling. Treatment primarily includes rest and ice to reduce swelling. Over time, players can begin stretching and strengthening exercise to help repair the heel area. Some players may need to wear orthotic heel cups to help cushion the heel or use athletic tape to help control foot movement that may promote excess movement and force on the heel area.
Prevention
The best prevention strategy against Sever's disease is choosing soccer shoes that fit properly. Soccer cleats that do not fit snugly or that fit too tight can either squeeze the foot or allow excess movement within the shoe that can lead to increased stress on the heel. Young players will probably need new cleats each year to compensate with their growth rates. Players should also warm up and stretch thoroughly before playing, to help loosen the area. Finally, players should wear footwear that matches the surface they are playing on, either indoor shoes, cleats or turf shoes.
