Heel pain in foot is a common complaint among runners. However, heel pain can be a symptom of several ailments such as Achilles tendonitis, flexor tendonitis, Achilles tendonitis, and plantar fasciitis. A podiatrists’ first question is if the pain is intense when you take the first steps in the morning or when you stand. Heel pain is severe in the morning, although a runner can easily walk it off and forget about the pain until the next morning. This condition requires understanding the physiology of the healing process. The tissues that are rope-like and fibrous are in a daily flux of breaking down for runners due to increased pressure on the feet. Since plantar fascia, Achilles tendon and toe flexor need to withstand the body weight during running. Deceleration forces tearing of the collagen fibers, but the fibers repair themselves. Heel pain from running can be because of running far or running too fast, but when given time, the tendons and tissues come back stronger.
If the tissues are not allowed time to recover, the injuries vary from chronic or acute injuries. If you are chronically injured, the body reacts by producing collagen in a disorganized manner. It causes the uncooked collagen fibers to appear like cooked spaghetti at the bottom of the pot in a process known as collagen cross-linking. Before maturity, the collagen fibers are delicate and healing occurs at night as we sleep. During such long hours of resting, ensure proper positioning of the tendons to allow cross-linking without re-tearing. A light stretch influences alignment of new collagen with extensive cross-linking before the maturation stage. Gentle stretch during the immobile periods prepares the tissues for weight bearing throughout the night.
Prevention of heel pain can be done by:
- Gently stretching before getting out of bed.
- Wear a night splint to stretch the plantar and heel of the foot.
- For the first steps in the morning, wear a supportive sandal or shoe. If you have an Achilles problem wear a high-heeled shoe. If you suspect plantar fasciitis, wear soft arch-supporting sandals.
On the first sign of heel pain, do the following
REST: Do not run, treadmill, or walk. Try exercises that will not put pressure on the heel; such as yoga, biking, weightlifting, and swimming.
ICE: Ice a bottle of water and roll it over the arch every evening for 20 minutes.
STRETCH: The calf needs to be stretched multiple times throughout the day using a belt or a towel and at least 30 seconds before getting out of bed. Perform the runners stretch throughout the day for a minute each time.
WEAR SUPPORTIVE FOOTWEAR: Avoid going barefoot; your shoes should be rigid and should bend at the toes. Grab your shoe upside down and try bending it. If it folds in the middle then it will cause pain, so throw it away. Lightweight shoes are good but they break down within a short time. Train in good shoes to avoid plantar fasciitis and if the shoes wear down change them to decrease the chances of getting injured.
If the above measures do not reduce heel pain from running in a few weeks, visit a podiatrist. The podiatrist will look further into the cause of the heel pain and treat it accordingly. Other treatment options to explore include the use of night splints, anti-inflammatory medications, prefabricated or custom orthotics, surgery, shockwave therapy, or cast boots. If you have any questions, or need to see a foot doctor in Houston, please contact our office in the Houston, TX area. Dr. Ejodamen Shobowale will answer any of your foot and ankle related questions.