Heel pain

[stuartj]

I’ve run about 25 miles a week for quite a lot of years, always the right shoes for over pronation, which I tend to do, but over the last month have developed bad right heel pain.

Done lots of stretches etc. but can’t seem to shake, and the one run I tried over that period made things a lot worse – anyone experienced a similar problem and found a fix, please?

[bales]

plantar fasciitis??

Sounds silly but get a tennis ball and roll it about under your foot (especially the arch) every night, this relieves pain in some cases - worked for my dad.

Edited by bales on Tuesday 30th March 15:45

[E21_Ross]

bales said:

plantar fasciitis??

good call, but wouldn't you also feel pain on the plantar surface, where the fascia runs. could be tendonitis or something.

how would you describe the pain and is it just on the back of the heel, all around it or what? do you notice any inflammation or redness there?

cheers

Edited by E21_Ross on Tuesday 30th March 15:55

[bales]

E21_Ross said:

bales said:

plantar fasciitis??

good call, but wouldn't you also feel pain on the plantar surface, where the fascia runs.

how would you describe the pain and is it just on the back of the heel, all around it or what? do you notice any inflammation or redness there?

cheers

Usually its at the base of the heel where the tendon attaches where you get the pain. If you have arch pain that is generally more related to shin splints and you usually suffer from both of them at the same time.

Just seen you said you overpronate on that foot too, thats a pretty classic cause as when the arch flattens it stretches the tendon more than usual and pulls on the attachment point.

Edited by bales on Tuesday 30th March 15:55

[E21_Ross]

bales said:

E21_Ross said:

bales said:

plantar fasciitis??

good call, but wouldn't you also feel pain on the plantar surface, where the fascia runs.

how would you describe the pain and is it just on the back of the heel, all around it or what? do you notice any inflammation or redness there?

cheers

Usually its at the base of the heel where the tendon attaches where you get the pain. If you have arch pain that is generally more related to shin splints and you usually suffer from both of them at the same time.

odd a member of my training group was diagnosed with plantar fasciitis by a physio and most of their pain was on the plantar surface/longitudinal arch of the foot. and surely it would depend on where the damage was in the fascia.

cheers

Edited by E21_Ross on Tuesday 30th March 15:58

[bales]

E21_Ross said:

bales said:

E21_Ross said:

bales said:

plantar fasciitis??

good call, but wouldn't you also feel pain on the plantar surface, where the fascia runs.

how would you describe the pain and is it just on the back of the heel, all around it or what? do you notice any inflammation or redness there?

cheers

Usually its at the base of the heel where the tendon attaches where you get the pain. If you have arch pain that is generally more related to shin splints and you usually suffer from both of them at the same time.

odd a member of my training group was diagnosed with plantar fasciitis by a physio and most of their pain was on the plantar surface/longitudinal arch of the foot. and surely it would depend on where the damage was in the fascia.

cheers

Edited by E21_Ross on Tuesday 30th March 15:58

Did he have flat feet and over-pronate badly? That usually gives arch pain as there are lots of little muscles tha get fatigued quickly as they can't control the foot adequately.

They are all related anyway as overpronation causes all of these symtoms but most people have the pain directly on the heel as it is the attachment point that becomes inflamed - they are also called heel spurs as bony growths can form with chronic sufferers of this just like bunions on your big toe joint.

http://www.sportsinjuryclinic.net/cybertherapist/f...

Edited by bales on Tuesday 30th March 16:10

[E21_Ross]

bales said:

they are know as heel spurs also.

yes and no, a heel spur can result from plantar fasciitis, but plantar fasciitis is not a heel spur. if that makes any sense at all

Heel spur is just (as the name suggests) a bone spur growing, usually on the inferior part of the calcaneus and points anteriorly. like this:

[bales]

Yeah I added this above!! It can cause it is what I meant! But your right a spur is a bony growth.

ETA - maybe the OP might want to comment now rather than us discussing heel spurs!

Edited by bales on Tuesday 30th March 16:15

[stuartj]

Thanks for such prompt responses – the pain seemed to start as stabbing pain at rear edge of right heel, but over a day or two it seemed the whole of the right heel (i.e. the bit which is in contact with the floor behind the arch of the foot) was sore – but no visible bruising or swelling.
The pain subsided a bit over three weeks without running, but then did a slow 3.5 mile jog and pain recurred quite severely. Now sore to walk on, and I’d say pain is more towards outer edge at rear of heel – and feels like very bad bruise.

[Barbotage]

As has been mentioned heel pain can be due to a multitude of factors and obviously difficult to diagnose over the interweb

stuartj said:

feels like very bad bruise.

I suspect this may actualy be closest to the mark! You clearly do alot of miles and this can result in contusion / bruising of the fat pad under the heel that cushions the calcaneum from the grounds impact, how many miles have you done in you current trainers (<500, or get some new ones) or have you recently increased / changed your running routine?
rest and a silicon heel pad is probably all that's needed.

Progressing on from this you could have developed a Calcaneal stress fracture - does it hurt if you squeeze the heel from both sides?

As mentioned above, Plantar Fasciitis is one of the commonest causes of heel pain,
Classicaly it will hurt here:

and tend to settle overnight, reccuring when you first put your foot to the ground in the morning and getting worse with weight bearing.
Best treated with rest, heel pad, and both TA and Plantar fascia stretching - but can take a long long time to settle which if you're like most of the runners I know, will drive you insane
The following NHS video by the delightfully named 'Emma Supple' gives an overview of things:
http://www.nhs.uk/Livewell/foothealth/Pages/HeelPa...

stuartj said:

the pain seemed to start as stabbing pain at rear edge of right heel

If it's a more shooting / stabbing / tingling pain or you've got any numbness then it's more likely to be down to compression of one of your hindfoot nerves (Sinus Tarsi Syndrome or less likely Tarsal Tunnel Syndrome)

Anyway, you've given it a chance to settle, and it hasn't, so probably best to get a definite diagnosis by seeing a sports physio / podiatrist / chiro etc etc
(I'll let Bill and E21_Ross fight it out as to which would be better )

[E21_Ross]

Barbotage said:

I'll let Bill and E21_Ross fight it out as to which would be better )

i'm for any method of treatment so long as it improves the condition

[bikerkeith]

I had similar symptom caused by running, I also have poor arches. It was diagnosed as tendonitis, which takes ages to heal as this part of the body has a poor blood supply. I eventually returned to running after 5 months, but kept my fitness up in the interim period by swimming.

Get a proper diagnosis from somebody with a specialism, rather than GP who will probably just tell you to take painkillers and don't use the affected limb.

[stuartj]

Many thanks, esp. Barbotage and bikerkeith, have taken your advice and now been referred by GP to specialist, will report back – you’re right about the insanity bit, I’m going stir crazy – I have always run early morning, and while am cycling etc. instead, I’m really missing pounding the streets…...

[stuartj]

Now definitively diagnosed as Plantar Fasciitis, with heel pad, wearing trainers and lots of stretches (esp. foot, gastocnemius and soleus) as the best fix – with steroid injection after 3 months if no better. Anyone found anything else which accelerated healing, please?

[bales]

stuartj said:

Now definitively diagnosed as Plantar Fasciitis, with heel pad, wearing trainers and lots of stretches (esp. foot, gastocnemius and soleus) as the best fix – with steroid injection after 3 months if no better. Anyone found anything else which accelerated healing, please?

Yeah a tennis ball like I said in the first post, do that every night and every morning for a couple of mins.