Recently, I had a conversation with two well-known sports editors and veteran on the subject of cleated shoes and how they affect the heel of the foot.

There concern is for the young athlete. Cleats are not supportive and may cause increased pressure on the heels, Achilles' tendon and arches of the feet. The more one plays, the more stress and strain is put on the joints, especially the growth plates of young feet.

Long-term complications may exist as the young athletes get older. If there is an injury, it can affect the bone growth due to the needed blood supply to the growing bone tissue. According to surveys, heel pain is the No. 1 foot ailment affecting Americans young and old.

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In the young age group, the pain is usually present in the back of the heel and is more pronounced in running and jumping sports. Sometimes there is a limp in the child's gait, of which they may not ever be aware. In the older age group, one will dread the first few steps in the morning when your heel hits the floor.

In addition to the trauma and stress created by running and jumping, sports or walking distance for exercise, there are other contributing factors that result in the inflammation of the growth plate or adult heel pain. These include biomechanical foot imbalances of abnormal pronation (inward rolling of the feet) or a high-arch foot. Cleated or improperly fitting shoes play a role as well as training methods.

Early treatment is a must, especially in the younger age group. Treatment should include X-ray evaluation to make a proper diagnosis and to rule out any bone fractures. In many cases, conservative therapy with an orthotic insert is often needed to correct the biomechanical imbalance and shock absorption which may be causing a jamming effect on the heel plate.

In addition, eliminate the use of any cleated shoes with less than four cleats in the heel area.