Heel Pain After Running

Pain in the heel is a common running injury. It can be caused by a number of different conditions, including overtraining, Achilles tendinopathy, and stress fractures. Other factors may contribute to the symptoms, including poor footwear and sudden changes in activity. Heel pain after running doesn’t only affect elite athletes, but can affect people of all ages and activity levels.

If left untreated, heel pain can significantly impact the ability to run and participate in daily activities. It is important for runners experiencing heel pain to seek help from a health provider to start treatment early and prevent further injury. There are several effective treatment options available, including physical therapy, load management, and medications.

Running And Injuries

Running is a popular and effective form of exercise that provides numerous health benefits. Many runners from all over the world experience improved physical and mental health from running. However, like any physical activity, running can lead to a range of different musculoskeletal injuries, including heel pain.

As running is a high-impact activity, it places a lot of load on the body. When the body is inadequately prepared or undertrained to manage these loads, it can increase the risk of injury. Various factors may contribute to the risk of running-related injuries. These risk factors can include

• Overtraining: One of the main risk factors is overtraining, which occurs when a person increases their running distance or changes activity intensity suddenly. This can put too much stress on the muscles, tendons, and bones, leading to injuries like heel pain.
• Running on uneven surfaces: Running on uneven surfaces, such as trails with rocks or roots, can increase the risk of asymmetrical loading of the joints in the leg or may even increase the likelihood of falls. These factors may contribute to foot injuries, such as heel pain.
• Wearing improper footwear: Wearing shoes that do not provide enough support or cushioning can put unnecessary strain on the feet, ankles, and legs, contributing to the risk of injury.
• Inadequate rest: After a sport or activity, the body and muscles need time to rest and recuperate. Without adequate rest between activities, it can reduce the time for necessary healing, thereby increasing the risk of injury.
• Muscle imbalances: Muscle weakness or areas of tightness, particularly in the lower legs and trunk, may reduce the ability of the body to withstand high-intensity exercises, like running. As a result, it may lead to running-related injuries.
• Biomechanical factors: Certain conditions, such as flat feet or overpronation (excessive inward rolling of the foot), can increase the risk of injury while running. It is important for runners to be aware of these factors and take steps to minimize this risk.
• Lack of a warm-up or cool-down: People underestimate the positive impact of warming up the body before exercise and cooling it down after activity. Skipping these can increase the likelihood of running injuries as it doesn’t allow the body to adequately prepare for exercise and gradually taper down after exercise.

When running is not done properly, or if a person overexerts themselves, it can lead to a host of different problems, including heel pain.

The Different Causes Of Heel Pain After Running (Not Plantar Fasciitis)

Plantar fasciitis is a common condition that occurs when the plantar fascia, a band of tissue that runs along the bottom of the foot, becomes inflamed and painful. It can cause a range of symptoms including heel pain when running. There are several other causes of heel pain after running that are not plantar fasciitis. Some of the other common causes of heel pain include:

• Achilles tendonitis: The Achilles tendon, which connects the heel bone to the calf muscle, can become irritated and sore with excessive load. This can be caused by overuse or a sudden increase in running intensity or distance, causing pain in the heel area.
• Stress fractures: Stress fractures are small cracks in the bone that can occur as a result of overuse or a sudden increase in training intensity. They are most common in the foot and lower leg, and can cause heel pain when running. It is important to seek medical attention if a fracture is suspected.
• Heel bursitis: A bursa is a small fluid-filled sac that cushions the heel and absorbs load and reduces friction between the bone and tendons. Inflammation of this bursa is called heel bursitis, and can be caused by overuse or wearing running shoes that do not fit properly. Heel bursitis may cause pain in the heel.
• Tarsal tunnel syndrome: This is a condition that occurs when the tibial nerve, which runs through the tarsal tunnel (a small tunnel-like structure that is made from the surrounding bone, ligaments, and tendons) in the heel, becomes compressed. It can cause heel pain, numbness, and tingling in the foot and ankle, particularly when running.
• Heel spurs: A heel spur is a bony growth on the heel bone that can cause pain when it rubs against the shoes or the ground. This can lead to pain in or around the structures in the heel.

It’s important that anyone experiencing heel pain after running gets early treatment, as this can help prevent the condition from worsening and allow an earlier return to running. Additionally, for any unusual or severe symptoms, seek medical attention immediately.

How To Reduce The Risk Of Running-Related Injuries

Heel pain can make it difficult to do the activities that runners enjoy, whether that is long-distance runs or sporting competitions. To prevent heel pain after running, there are several treatment options.

A great starting point is talking to a physical therapist. Physical therapists are trained to assess and treat a range of running-related injuries, including heel pain. Physical Therapy can help reduce pain, improve flexibility and strength, and manage training load.

A thorough assessment is used to identify any issues, such as calf strength or joint stiffness. From this, a diagnosis of the underlying condition that is causing the heel pain can be made. Physical Therapists can then use a range of techniques, including running-specific exercises, Pilates, massage therapy, and taping, to alleviate pain and allow the body to heal. The physical therapist may also make a referral to other health disciplines, such as a doctor or podiatrist, for more specialized treatments such as medications or orthotics. By working with a Physical Therapist, individuals with heel pain can start a customized treatment plan that addresses their specific needs and helps them recover faster.

Other treatments for heel pain may include a gradual training program, wearing proper shoes, and listening to the limits of the body. It is also helpful to cross-train and incorporate other forms of physical activity, such as Pilates or swimming. This can help give the body a break from the repetitive loads of running and build strength before returning to running. Additionally, it can be helpful to start a running-specific training program that targets common areas of muscle imbalance, inflexibility, or weakness from running. As technique is a large part of running well, it can also be helpful to undergo a running gait analysis with a trained clinician.

Running Gait Analysis

At Ironhorse Physical Therapy & Pilates, we offer a thorough running gait analysis to help our running patients improve performance and reduce the overall risk of injury. Our analysis includes:

• Comprehensive musculoskeletal assessment: Our physical therapists analyze strength, range of motion, and biomechanics to ensure that everything is functioning normally.
• Discussion of training plan and goals: Our physical therapists want to ensure we are on the right track, and tailor our approach to each individual patient and their specific needs (depending on their goals).
• Video analysis of running technique: Our physical therapists ask our patients to run on a treadmill, so we can record front, back, and side views of the running technique. We can slow down certain moments to show our patients what they are doing well and what can be improved to reduce pain and other symptoms.
• Actionable changes: From this analysis, our physical therapists can make actionable recommendations to improve running performance and help runners to exercise pain-free. This may include a change in footwear, load management strategies, corrective exercises, and a running-specific strengthening program to address any areas of weakness or dysfunction.

If this sounds like it could be of benefit, get in touch with one of the physical therapists at Ironhorse Physical Therapy & Pilates to discuss all the options for running.

Treat Heel Pain Early

Heel pain is a common issue that can affect runners of all levels. It is important to address heel pain early on in order to prevent it from worsening and potentially leading to more serious injuries. There are several effective treatment options available for heel pain, including physical therapy and load management. By seeking treatment from a physical therapist and following a tailored management plan to address the root cause of the heel pain, runners can effectively manage their discomfort and get back to their training routine.

Want to enjoy running for years to come? Contact our experienced team at Ironhorse Physical Therapy & Pilates to improve running performance and reduce the risk of running-related injuries.

References

ASICS. How To Treat Heel Pain After Running. Available from: https://www.asics.com/gb/en-gb/running-advice/how-to-treat-heel-pain-after-running/

Running Science. Running with heel pain. Available from: https://runningscience.com.au/running-with-heel-pain

Physiopedia. Running biomechanics. Available from: https://www.physio-pedia.com/Running_Biomechanics

Physiopedia. Assessment of running biomechanics. Available from: https://www.physio-pedia.com/Assessment_of_Running_Biomechanics