If you coach or have coached kids at the U10-U14 level, especially at the competitive level, you are probably familiar with heel pain. But you may not know what causes it and why it can sometimes seem like players are always having heel trouble.
Last year, one of my players was having severe heel pain. I first thought this to be the result of an ankle strain but it did not improve with typical rest time. I also noticed that the way the player walked and ran changed significantly. Soon my own son felt the same pain and experienced the same hitch in his walk.
These were my first exposure to Sever’s Disease. Now, several of the players I train have the same problem.
The good news is the condition is manageable and is unlikely to cause any permanent damage. But it still hurts. Thankfully the remedies are pretty straightforward.
One of my players went to see a podiatrist and he explained that the pain was due to inflammation of the heel. Specifically, in children there is a growth plate on the back of the heel. In kids that play sports, until the plate fuses to the main part of the heel (as teenagers), shearing forces on the plate from the Achilles tendon and any trauma to the heel can cause pain and it can be intense.
So what are the experts saying? Soccer cleats are very hard on the feet, and the hard ground most kids play on doesn’t help. Competitive soccer can result in trauma and inflammation of the growth plate until the bones fuse together. An easy way to tell if a player is having this problem is to squeeze the sides of their heel. It’ll hurt when you do. Some will tell you without the ‘squeeze test’ that the sides of their heel hurt in a place that seems odd if you’re used to dealing with ankle sprains.
Treatment and preventative options include:
- RICE: Rest, Ice, Compression, Elevation. The RI part anyway. Heels should be iced 15 minutes a day, 1-3 times a day, even on days they don’t hurt, to help control the inflammation.
- Reduce or stop activity if necessary due to the pain. Some recommend stopping sports activities completely, while others note that permanent damage is unlikely and to use the pain as your guide – if it’s managable with ice and other treatment/preventative measures, they likely will be fine if they ease back to let the inflammation subside and take other preventative measures.
- Stretch the calf muscles daily to reduce the strain on the Achilles tendon and thus the growth plate.
- Heel gel pads – though my players have found they tend to make it hurt worse in cleats. But reading these articles, it sounds like everyday walking at school is when the pads will help the most.
- Wear cleats just for practices and matches. DON’T wear cleats to the car, walking across the parking lot/sidewalks. Another option is having players wear turf cleats for practice.
- Wear quality shoes with solid arch support and cushioned soles to reduce shock to the heel.
Obviously you should consult a specialist if the pain is intense or nagging. But some common sense steps like stretching and rest/ice may be able to prevent a small injury from becoming a big one that sidelines a player.