If you’re a runner, you know the joy of hitting your stride. But heel pain can quickly sideline you, impacting both your performance and your enjoyment of the sport.
Heel pain in runners can stem from a number of issues, which is why getting the right diagnosis and treatment plan is crucial. Ignoring that pain can lead to chronic problems and a much longer recovery time.
This guide will give you a complete overview of common running heel injuries. We’ll cover conditions like plantar fasciitis and Achilles tendinitis, as well as prevention tips, treatment options, and advice on when it’s time to see a doctor.
We’ll also emphasize how important it is to take a holistic approach to recovery and prevention, including changes to your running form, lifestyle, and footwear.
Common causes of heel pain in runners
Heel pain plagues many runners, from weekend joggers to marathoners. Here are some of the most common culprits:
Plantar Fasciitis
Plantar fasciitis involves inflammation or tissue damage to the plantar fascia, the thick band of tissue that runs along the bottom of your foot and supports your arch. It’s often triggered when you suddenly increase your training or come back to running after a break.
The pain is typically sharp and located under your heel. It’s often worse after you’ve been inactive for a while, like first thing in the morning.
Risk factors include running more than usual, being between 40 and 60 years old, being overweight, and having flat feet or high arches. Women are also more likely to develop plantar fasciitis, especially if they often wear high heels or have gained weight during pregnancy.
Achilles Tendinitis
Achilles tendinitis is inflammation of the Achilles tendon, which connects your calf muscles to your heel bone. Running hills or climbing stairs can aggravate this condition. Tight calf muscles are a major contributing factor.
Symptoms include pain, stiffness, and tenderness along the tendon. If you don’t treat it, it can become a chronic problem.
Other Potential Causes
Heel pain can also stem from other issues, such as:
- Stress fractures in the calcaneus (heel bone) or navicular bone, caused by repeated stress and not enough recovery time.
- Nerve irritation or entrapment, which can lead to burning, tingling, or numbness in your heel and foot.
- Sever’s Disease, a common cause of heel pain in children, related to stress on the heel bone. This typically affects kids aged 8-15 who are involved in running or jumping sports.
Diagnosis and Assessment
It’s really important to get an accurate diagnosis so you can get the right treatment. It’s tempting to self-diagnose, but that can lead you down the wrong path. A healthcare provider can figure out what’s really causing your heel pain.
They’ll start with a physical exam, checking how your foot moves, feeling for sore spots, and watching how your foot works when you stand and walk. They’ll also want to see you run, if possible, to spot any problems with your form.
Sometimes, they’ll order imaging tests like X-rays (to check for fractures) or an ultrasound or MRI (to look at the soft tissues). These aren’t always needed, but they can be helpful if the cause of your pain isn’t clear.
Initial Treatment: Pain Relief and Reducing Inflammation
If you’re dealing with a heel injury, start with these strategies to help ease the pain and bring down any swelling:
- Rest: Cut back on your running mileage and skip any activities that make the pain worse. Instead of stopping exercise entirely, consider cross-training to stay in shape without putting stress on your heel.
- RICE Method:
- Rest: As mentioned above, reduce or modify activity.
- Ice: Apply ice for 15-20 minutes several times a day to reduce inflammation.
- Compression: Use a bandage to compress the area and minimize swelling.
- Elevation: Keep your foot raised above heart level to encourage fluid drainage.
- Over-the-counter pain relievers: Medications like ibuprofen (Advil) or naproxen (Aleve) can help manage pain and inflammation. Be sure to follow the instructions on the label and talk to your doctor if you plan to use them for more than a few days.
- Stretching: Gentle stretching exercises can improve flexibility and reduce tension in your plantar fascia, calf, and toes. Hold each stretch for 30 seconds to 1 minute, repeating several times a day. You can also incorporate some dynamic warm-up exercises before you run.
- Footwear modifications: Wear supportive running shoes that provide good arch support and cushioning. Avoid running in worn-out shoes, and replace them regularly. You might also consider using orthotics for extra support and to correct any issues with your foot mechanics.
Advanced treatment options and professional interventions
If rest, ice, and new shoes aren’t enough to get you back on the road, don’t despair. There are several other strategies that can help you recover from running-related heel pain.
Custom orthotics
Custom orthotics can provide individualized support and correct your foot mechanics. They may help relieve pressure on the plantar fascia and/or Achilles tendon. Orthotics can be prefabricated or custom-molded to your feet. You can even get 3D-printed orthotics these days.
Physical therapy
A physical therapist can design a personalized exercise program to strengthen your calf muscles, plantar fascia, and all the structures that support your foot and ankle. These exercises might include calf raises, toe curls, and towel scrunches. A physical therapist can also teach you how to improve the resilience of your tendons with eccentric strengthening exercises.
During a session, a physical therapist can also analyze your running gait and correct any biomechanical imbalances that may be contributing to your injury. This analysis can help you reduce the impact of your foot strikes and improve your running efficiency. You might work together on low-impact running techniques such as taking shorter strides and landing more softly.
Other interventions
- Night splints. Worn while you sleep, night splints keep your foot in a dorsiflexed position, which helps stretch the plantar fascia.
- Kinesiology taping. This type of taping provides support and reduces strain on the plantar fascia or Achilles tendon.
- Injections. Corticosteroid injections can reduce inflammation in severe cases. However, these injections should be used with caution because of potential side effects and limited long-term benefits.
- Laser therapy. Some sources mention laser therapy, but its effectiveness hasn’t been definitively established.
How to Prevent Heel Injuries
The best way to manage running injuries is to avoid them in the first place. Here are some strategies that can help.
- Ramp up slowly: Don’t suddenly increase how far or fast you run. Experts recommend increasing your running speed or distance by no more than 10% each week.
- Warm up and cool down: Do stretches that move your joints through their full range of motion before you run. When you’re done, hold stretches to cool down.
- Wear the right shoes: Get fitted for running shoes based on your foot type and running style. Change them out regularly so they maintain their cushioning and support. Some runners with heel pain have found relief with Brooks’ Adrenaline GTS.
- Build strength: Strengthen your calf muscles, the small muscles in your feet, and your core to improve your stability and help your body absorb shock.
- Stay at a healthy weight: Maintaining a healthy weight reduces the stress on your feet and other joints. Even losing a little weight can ease the burden on your plantar fascia.
- Skip the high heels: High heels can put you at risk for plantar fasciitis.
- Listen to your body: If you feel pain, slow down or stop. If it doesn’t go away, see a doctor or physical therapist.
Conclusion
Heel pain is a common problem for runners, but it’s often manageable, and it’s frequently preventable. The sooner you take action, the better the outcome is likely to be.
The best way to keep heel pain at bay is to take a comprehensive approach. Make sure you’re training properly, wearing the right shoes, stretching regularly, and making any necessary lifestyle changes.
If your heel pain is severe or doesn’t respond to home treatment, talk with a healthcare professional. They can help you create a personalized treatment plan that addresses your specific needs and risk factors.