WHAT ARE THE CAUSES OF HEEL PAIN FROM RUNNING?
Heel pain from running can be due to a number of conditions, including plantar fasciitis, structural or muscular issues or imbalances in the lower leg and foot, or sometimes even your biomechanics (improper gait pattern). During your consultation, your sports podiatrist will carry out a comprehensive examination in order to determine the cause of your heel pain from running. This will include taking into account your previous and current running and other exercise history, checking your range of motion in the lower leg, gait assessment and if required, medical imaging, such as x-ray or ultrasound imaging.
Many Australians enjoy going for a run. It is an inexpensive and convenient form of exercise, however it is common for some people to experience heel pain from running at some point during their lives. If you are suffering with heel pain, it is important that you see a suitably qualified sports podiatrist sooner rather than later. Pain is a sign that there is a problem occurring somewhere. Ignoring and pushing through the pain can lead to further strain, injury, or other complications associated with the condition.
Plantar fasciitis is commonly a cause of heel pain from running. The plantar fascia is the thick, flat band of tissue (ligament) that runs along the base of your foot, connecting your heel bone to your toes. When plantar fasciitis occurs, the plantar fascia becomes inflamed and thickened due to irritation at the attachment point at the base of the heel. People who suffer with plantar fasciitis often feel pain directly under the ball of the heel. Sometimes they have associated arch pain too. The pain is most commonly felt first thing in the morning or immediately after resting, such as when you have been lying or sitting down and then stand to walk. The heel pain can be persistent or intermittent. Occasionally, if there is a sudden onset of pain, this can indicate micro-trauma, or tearing, of the plantar fascia.
Achilles tendonitis is a condition that causes back of the ankle and heel pain from running. The Achilles tendon is a fibrous cord that attaches the back of your calf muscles to your heel bone. In people suffering with Achilles tendonitis, this tendon becomes irritated and inflamed, particularly in the area where it attaches at the back of the heel. Redness and swelling is sometimes visible with the naked eye in the sore area, and in some patients, a bump or lump can be felt in the tendon as well. There are a number of factors that contribute to the development of this painful condition: tight calf muscles that impede the range of motion at the ankle joint, overweight or obesity, and poor gait biomechanics are amongst the most common causes of heel pain from running.
A heel spur is an abnormal bony projection that develops around the heel bone. It is commonly misunderstood that these spurs cause heel pain from running. Most health practitioners now generally accept that heel spurs are not the cause of the pain, but rather that the pain experienced is because of the inflammation of the tissues around the location of the heel spur. Heel spurs are most commonly either at the back of the heel, when associated with Achilles tendonitis, or under the base of the heel if associated with plantar fasciitis. Heel spurs tend to form over many months, when there is constant strain or pressure on the foot muscles, ligaments and/or tendons.
Bursitis quite often causes heel pain from running, and the pain may be worse at night, while stiffness worse in the morning. The bursae are little fluid-filled sacs that sit between two neighboring muscles, tendons or bones. Their purpose is to reduce resistance, or friction, between these structures and to allow the tendons to move smoothly over bony surfaces without injury. Bursitis develops when these sacs become inflamed. Too much repetitive movement and strain to the bursae usually cause this painful condition, or injury to the tissue found inside the bursae. People that suffer from bursitis may experience sharp or shooting pains and there may be visible redness and swelling.
TREATING HEEL PAIN FROM RUNNING
Your sports podiatrist will conduct a thorough examination and subsequently will be able to recommend the most appropriate ways to treat your heel pain from running. A few of the common treatments include:
Shock wave therapy
Shock wave therapy is used across many medical fields. It is non-invasive, and has the potential to relieve pain almost instantly. A special probe is used to direct bursts of high-energy sound waves into the painful area, where they make contact with the tissues. The brain is signaled to promote repair of the injured or inflamed tissues through this process.
Your podiatrist will prescribe the most suitable stretches for you to practice as part of your treatment. Be mindful that some stretches may aggravate or irritate injured and inflamed tissues, so it is always best to check with your therapist prior to undertaking any aggressive stretching.
Ice is a safe, easy and convenient way to relieve your heel pain from running. Icing helps to reduce the pain by decreasing inflammation in the affected tissues.
PREVENTING HEEL PAIN FROM RUNNING
Being observant of some preventative measures is important while you continue with your podiatrist’s prescribed treatment plan, so that you can avoid worsening the underlying cause of your heel pain from running.
Stretch and warm up
Running puts a lot of pressure on the tissues of your feet. Taking a few moments to do some basic stretches before and after you run can really help to reduce your heel pain from running. Ask your sports podiatrist for their advice as to which exercises are most appropriate for you. Some of the types of warm up exercises they may suggest might include foot and ankle stretches and stretches for your calf muscles.
Work to improve your foot strike pattern
Your sports podiatrist may conduct a running gait assessment as part of their examination. A rear-foot strike pattern is common with most people, where the heel hits the ground first. It is thought that this contributes to the development of heel pain from running. Your podiatrist may request that you try to change to a mid-foot striking pattern and see if that helps with reduce your heel pain, however this is not always applicable for everyone.
Aim to maintain healthy weight
Being overweight puts extra and unnecessary pressure on your legs, and especially your knees, ankles and heels, when you run. Aiming to reduce your excess body weight will help you be lighter on your feet and give you greater balance when you exercise, not to mention the other overall general health benefits! This will help you in maintaining a healthy gait/foot strike pattern as you run, and in turn will reduce your heel pain from running.
Support the structure of your feet
Investing in a pair of sports shoes specifically made for runners is key in preventing your heel pain from running. Ask your sports podiatrist for their recommendation on what types of runners are suitable for your foot. Everyone’s feet are different, so it is important that you buy shoes that support the structure of your feet. If it is beneficial, your podiatrist will also be able to recommend a strapping technique for you.
The information provided in the article above should not be taken as general advice and is for informational use only. If you are suffering with heel pain from running, you should consult with an appropriately qualified sports podiatrist to discuss your individual concerns. You can make an appointment online at www.sydneyheelpain.com.au or by calling 93883322.
Written by Karl Lockett