The evaluation of cleated shoes with the adolescent athlete in soccer

J H Walter and G K Ng

The Foot

September 2002, Volume 12, Page 158 - 165

Podiatrists John Walter and Gregory Ng investigated soccer shoe position in youth soccer players, to determine if the 'cleats' on the soles of the shoes placed the children's feet in a dorsiflexed or 'negative heel' position. The authors defined a negative heel postion as 'a foot that is in a dorsiflexed position throughout the stance phase of running' - that is, the heel is lower than the forefoot when the foot is on the ground during running. This could be assessed subjectively if the player was observed to be 'running on their heels'.

Walter and Ng used an F Scan in shoe pressure sensor device as well as videotape analysis to assess foot position in 36 males aged 8 to 11 years in both cleated and non-cleated shoes. Frame by frame video analysis revealed the length of time between heel strike and heel raise was increased in cleated shoes. F Scan measurements of pressure distribution revealed a delayed heel lift and increased rearfoot pressure, as well as increased pressure on the sole of the foot, in cleated shoes.

The significance of these findings are related to the incidence of Sever's 'disease' - a traction apophysitis of the Calcaneus. This condition is relatively common in adolescent soccer players and a negative heel position is thought to increase the predisposition to 'Sever's'. So if cleated shoes put the foot in a negative heel position, why don't all children wearing soccer shoes get Sever's? Presumably because the cause of Traction Apophysitis conditions is multi-factoral - depending on hormonal changes, growth, bone health, calf muscle flexibility, training surface and training load - as well as footwear and foot position.

As with most overuse injuries, the risk of acquiring Sever's can be minimised by maintaining (calf) muscle flexibility, gradually progressing training (particularly during and just after 'growth spurts'), and by using an accustomed training surface. The findings of this study would suggest that a running technique where the player runs 'on his heels' should be discouraged and old soccer shoes which curl up at the front should not be used. An orthotic or heel raise may also help to prevent Sever's disease based on the findings of this study.

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