Cleats for heel pain and Sever's disease: what a cushioned cleat can and can't do for a 9- to 14-year-old

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What Sever's disease is

KidsHealth (Nemours), medically reviewed January 2019: “Sever disease is a swelling and irritation of the growth plate in the heel.” The growth plate is cartilage at the end of the bone where growth happens, and it is weaker than the bone around it. Kids usually develop it between ages 9 and 14 during growth spurts, when bones, muscles and tendons grow at different rates; activities and sports “pull on the tight muscles and tendons, injuring the growth plate.” Running and jumping sports on hard surfaces raise the risk. Symptoms the page lists: pain or tenderness in one or both heels, swelling, stiffness on waking, limping, tenderness when the heel is squeezed, worse with activity and better with rest. Most cases, per the page, resolve in two weeks to two months with rest, and it typically does not recur after about 15 when the growth plate closes.

Two things follow for a baseball parent. It is common, it is a growth thing rather than a cleat thing, and it gets better. And the cleat is a factor the page addresses directly: well-fitting shoes with padded soles help, and hard, flat, thin soles on hard ground make it worse.

What the pediatric source recommends

Quoting and summarizing KidsHealth: ice for 15 minutes every one to two hours, pain medication as a doctor advises, gel heel cups or supportive shoe inserts, shoes “that are open in the back so the heel is not irritated” when off the field, compression wrapping, physical therapy, and in some cases a walking boot. For prevention: well-fitting shoes with padded soles, stretching before and after activity, and icing after. Rest is the treatment; a cleat is a supporting actor.

What to look for in a cleat

• A named midsole. Most youth cleats have a thin foam sliver. The New Balance 4040v8 lists a full-length FuelCell midsole; the Mizuno Lightrevo Jr lists an EVA midsole and a Wave plate the maker says disperses impact; the UA Leadoff Jr lists an EVA midsole that “evenly distributes cleat pressure.” Those are the three on this page for that reason.
• Molded, not metal. A rigid metal plate is the opposite of what a sore heel wants, and it is not legal for most of the ages Sever's affects anyway (see molded vs metal).
• Room for a heel cup. A gel heel cup adds a few millimeters under the heel; a cleat with a removable insole and a half size of room takes it without cramping the toes.
• A padded collar. The UA Leadoff Jr lists padded collars and heels; a hard collar rubbing an inflamed heel is a second injury.
• Fit, laced. Heel slip in a too-big cleat rubs the exact spot. The sizing guide has the thumb test.
• A turf shoe or sneaker for practice. Cleats on a hard practice surface are the worst case; KidsHealth names hard surfaces as a risk. Practice in cushioned shoes when the coach allows it.

Heel cups and inserts

KidsHealth lists gel heel cups and supportive inserts among the treatment approaches. We do not rank heel cups (we could not source specs from a maker's page we can read), so the guidance is generic: a gel cup that fits under the cleat's insole, worn in both shoes so the kid does not stand unevenly, sized to the kid's shoe size, and fitted into a cleat that has the room. Ask the doctor whether a cup or a full insert is the right one for your kid.

Three cushioned picks