What heel pads should be used for Sever's Disease?

Heel pain is one of the most common reasons for pain in the feet. The most common reason for pain in the heel in adults is plantar fasciitis and the most common reason for heel pain in children is a condition known as Sever’s disease. Sever’s disease is a condition of the growth plate at the back of the heel bone that is especially common in kids that are active and mostly causes pain at the back of the heel. As the problem is related to the growth of the bone, the problem goes away by itself when the growth in that bone has finished. It is however, painful and limits the activity of the child so still needs to be treated to help that even though they will eventually growth out of it. The key to managing this problem is cutting back exercise and other activity levels down to an amount that the pain in the heel is tolerable. It is often hard to get children to comply with this.

The other approach is to use heel pads for Severs disease. These Sever’s disease heel pads can come in a variety of types and some will have no affect. The idea behind the pad is that they need to cushion the impacts of the heel on the ground and they also need to raise the heel up so that the pull of the Achilles tendon on the back of the heel bone. All too often the pads that are used do not achieve those aims. For example a padding material may feel quite soft between the fingers when you feel it, but if your fingers can flatten the padding, then it is going to do nothing under the foot as the bodyweight of the child will easily flatten it. These types of pads will do nothing to cushion the impacts on the ground or reduce the stress from the Achilles tendon. At the other end of the spectrum is a pad that is too hard that is going to work at reducing the pull of the Achilles tendon but will do nothing to cushion the impacts. The ideal padding for this will be a compromise to achieve the two aims. It needs to be hard enough to reduce the pull from the Achilles tendon but not too hard that it can not absorb the impacts from the ground. The pad may also vary depending on the body weight of the child, with the heavier child needing a firmer pad that they do not compress. Often the most commonly used material for this Sever’s heel pads is a firm silicone gel like material. The softer gel materials tend to be too soft for this and are easily compressed. Sometimes a good running shoe can do this and some even have a silicon gel material under the heel in them. This can also be found in some football boots. Some clinicians might use an EVA type of material which is a good alternative to the gels based materials.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.