Can I Still Run with Heel Pain?

Mar 16, 2020

At Capital Podiatry Associates, we see a ton of runners come in with heel pain symptoms.

Some have it so bad that that they’re on the verge of giving up something that they’ve loved doing for years. Many say that, even if they take a few days or a few weeks off, the pain just comes right back as soon as they attempt to restart their routine.

It’s obviously extremely frustrating. And the last thing we want is for our patients to be unable to live their lives to the fullest.

Fortunately, there is hope for runners suffering from heel pain. Although your treatment plan may require you to take a brief break from your activity, we can help you identify and deal with the fundamental causes of your heel pain—so you can go back to the activities you love!

But also, you need to understand this:

If running is starting to cause more and more pain, don’t take chances with your long-term health! Stop what you’re doing and make an appointment with our office. Let’s quickly find and address the cause of your problem before you have an opportunity to do more lasting damage.

Can I Still Run with Heel Pain?

Why Running Can Wreck Your Heels

The simplest explanation is this:

Running is a very high-impact activity. Each time you land, your foot has to bear an impact force equivalent to several times your own body weight, in a fraction of second, across a relatively small area. And your heels are the first part of your foot to come into contact with the ground.

Naturally, if you are a regular runner, the cumulative stress of all these repetitive impacts can cause an overuse injury. Running keeps breaking down the tissues that connect with and support your heel, and they don’t get enough time to rebuild themselves before the next wave.

However, this explanation alone isn’t quite sufficient. After all, there are lots of avid runners that don’t have constant heel pain. What makes your case different?

Finding the answer to this question is why it’s so important that you make an appointment to see us.

See, while the vast majority of heel pain symptoms from running can be broadly categorized as “overuse injuries,” the actual mechanisms that cause them can be quite varied. For example, any or all of the following could be factors in your situation:

  • Poor or inappropriate shoes
  • Training mistakes
  • Structural problems with your feet (flat feet, high arches, overpronation, etc.)
  • Abnormal or inefficient gait mechanics
  • Injuries or weakness in other parts of the body that disrupt your biomechanics

Likewise, the specific heel pain diagnoses are just as varied. While plantar fasciitis is no doubt the most common heel pain condition, many other conditions with similar causes and symptoms are possible, including Achilles tendinitis and stress fractures. A different injury, to a different type of tissue, in a slightly different area of the body may require a very different treatment approach!

Man wearing ankle brace

Finding the Culprit

When you come to our office, we’ll perform a thorough evaluation of your condition and talk with you at length about your lifestyle, your running routine, and your symptoms.

We also encourage you to take an old pair of running shoes along with you so we can take a closer look. Not only can this help us tell if you’re wearing proper shoes, but observing the tread wear can also sometimes give us subtle hints about your foot and ankle biomechanics.

Our office is equipped with not just an on-site digital X-ray, but also an ultrasound. This allows us to get clear, instant images of both the soft tissues and bones that make up your heel and the surrounding region.

It’s also important to get really specific about how you are feeling. Is the pain worst during your run, or afterward? Is it intense and localized in a specific spot, or diffused across a wide area? Does the pain come on suddenly, or build gradually?

You might feel a little overwhelmed by the questioning at first, but trust us—the more we know about your circumstances, the better we can customize our treatment recommendations to your specific needs. That means better odds of eliminating your heel pain and returning to running as soon as possible!

Runner tying shoes sitting down on a track

Helping You Run Again—Without the Pain

Now, armed with all that information, we can start to put together a treatment plan that focuses on both alleviating your symptoms and addressing the root causes. It’s really that second part that’s most critical for our avid runners!

One treatment option our runners especially love is an advanced therapy that actually does a great job addressing both the symptoms and many of the root causes—MLS laser therapy. This is a non-invasive, painless, and drug-free form of treatment. It is not only extremely effective at fighting pain and inflammation, but actually accelerates your body’s natural tissue repair mechanisms. It’s a great option for almost every major cause of running-related heel pain, including plantar fasciitis, tendinitis, and more.

If you’d like to know more about this exciting option, including how it works and what it could do for your heel pain, please read our in-depth blog on the subject!

Other symptom-focused treatments might include things like cortisone injections, physical therapy, icing the heels, and (temporary) rest.

But as we said, alleviating a specific painful episode is only one part of a complete solution. The goal is to get you to the point where you can go back to running regularly without continuing to hurt yourself again and again.

We find that many, if not most of our runners with heel pain greatly benefit from a well-chosen pair of either prefabricated arch supports or custom orthotics. These devices can serve many essential purposes, including offloading more weight and pressure away from the heels, absorbing some of the impact shocks, and even putting your feet and ankles back into a more biomechanically efficient alignment and gait pattern.

The key phrase here, though, is well-chosen. Don’t fall into the trap of believing that an insole bought off the wall at a drugstore is going to do you much good—even if some kiosk with a pressure plate told you what to buy! That’s no substitute for the analysis and evaluation of a podiatrist, and orthotics that aren’t correct for your feet or running style are just going to waste your money without giving you much in return.

Woman checking time on smart watch during run

Depending on what we determine caused your heel pain, we may make further recommendations to help you prevent it in the future, such as:

  • Get better running shoes. It’s important for runners to find running shoes (specifically) that fit great and match their running form/pronation style. (Generic athletic shoes won’t do.) They also need to be replaced promptly if they are worn out, which typically happens after 250-400 miles of use.
  • Pace yourself. Running beginners, as well as those who start up again after a long break or significantly increase their mileage in a short period of time, are more prone to heel pain (and other injuries, too). Start at an easy pace, then increase your routine by a maximum of 10% per week.
  • Give your heels enough rest. Running long distances every single day will typically lead to heel pain, since you never give your heels a break to rebuild themselves after wearing them down. Make sure you build enough rest days into your schedule. You can cross-train in low-impact workouts (swimming, cycling, weight training, etc.) on your rest days to maintain and improve fitness while still “resting” your heels.
  • Consider your terrain. If you typically run on a lot of hard surfaces, consider heading out to the trail or the park to run on softer surfaces like grass or earth instead. That said, if you have to stick to hard surfaces, asphalt is a big improvement over concrete.

It may take some trial and error to figure out what works best for you, but with an accurate diagnosis, effective treatments, and a little bit of discipline, you prospects for returning to pain-free running are looking very good indeed!

But you need to take that first step. To schedule an appointment with Capital Podiatry Associates in Alexandria, give us a call today at (703) 560-3773.

 

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