Below are descriptions of common running injuries to the back of the heel or ankle. In the case of overuse injuries such as Achilles tendonitis and retrocalcaneal bursitis, the pain may be mild at first and gradually get worse. Achilles tendonitis Symptoms of Achilles tendonitis can include pain, skin redness, and swelling just above the heel.
The Achilles tendon connects the calf muscles to the back of the heel bone, called the calcaneus. If the tendon becomes irritated and inflamed it is called tendonitis. Though it can affect athletes and non-athletes alike, Achilles tendonitis frequently occurs in runners who ramp up their training too quickly or whose calf muscles are too tight. Symptoms may be worse first thing in the morning or after a workout. Rest and other non-surgical treatments can usually relieve symptoms.
However, blood flow is limited in this area of the body, so Achilles tendonitis can be slow to heal. Podiatric Dermatology.
Begin Print Subscription. Renew Print Subscription. Tim Dutra, DPM. Keywords sports medicine. Copied to clipboard. Here is the system I have developed: Type 1: pain after activity Type 2: pain during activity, not restricting activity Type 3: pain during activity, restricting activity and performance Type 4: chronic, unremitting pain What You Should Know About Treatment Approaches There is a two-pronged approach to treating heel pain.
The initial treatment of heel pain consists of the following: Rest. Pads and orthotics. Options include prefabricated or custom orthoses. Night splints. Consider night splints, especially in recalcitrant cases. Evidence-Based Sports Medicine. BMJ Books, London, Neurogenic heel pain. Clin Podiatr Med Surg. Lui E. Systemic causes of heel pain.
Dellon AL. Deciding when heel pain is of neural origin. J Foot Ankle Surg. Aspects of treatment for posterior heel pain in young athletes. J Sports Med. Tu P, Bytomski, J. Diagnosis of heel pain. Am Fam Phys. Toomey EP.
Plantar heel pain. Foot Ankle Clin N Am. Williams SK, Brage M. Heel pain-plantar fasciitis and Achilles enthesopathy. Clin Sports Med. Aldridge TA.
Diagnosing heel pain in adults. Pediatric heel pain. Painful prominences of the heel. Pathological conditions of the heel: tumors and arthritidies. Aronow MS. Posterior heel pain. Heel pain in the athlete. Sports Health. Solan M, Davies M.
Management of insertional tendinopathy of the Achilles tendon. Forman WM. Heel pain. This article is the third in a series about the basics of wound care. The topic covered in this installment is debridement, an important part of wound bed preparation. Recently published research took a closer look at the effects of employer-offered high-deductible health care insurance plans on low-value spending in the privately insured population.
Follow us on Twitter. Specialties Autoimmune. Clinical Pathways. Your foot mechanics also play a role. If you are flat-footed, have high arches or an abnormal walking pattern, these can all affect weight distribution on your foot and increase stress on the plantar fascia.
Running with these poor mechanics worsens the problem. Other factors include age, with those between 40 and 60 having the highest risk. Being overweight and spending long periods of time standing on your feet may contribute to this condition too. Plantar fasciitis is stubborn and often difficult to cure. Rest is the first line of treatment for this condition.
Staying off the sore heel for at least a few days — potentially longer — will allow the inflammation to recede and treatment to be more successful. One of the major barriers to proper treatment of plantar fasciitis in runners is that they often don't want to take time off from running. The longer plantar fasciitis is left untreated, the more difficult it is to resolve. Therefore, it's important not to keep running when the fascia is inflamed. During this time, icing your foot will further reduce pain and inflammation.
Either place your heel on an ice pack, or stick your foot in an ice bath. Do this for 10 or 20 minutes at a time on the hour or as often as you can throughout the day. Stretching is also a key part of treatment. Stretch the calf muscles for five minutes three times a day with a simple wall stretch. Keep the back leg straight to stretch the gastrocnemius muscle; then bend the back leg slightly to stretch the soleus muscle.
You can also stretch the plantar fascia by flexing your ankle and pulling your toes toward you. Once plantar fasciitis is under control, you can take steps to reduce the risk of recurrence. Metzl recommends running on soft surfaces, such as trails and grass, and being conservative when increasing your mileage and intensity.
You should also wear proper footwear for your foot type and gait both when you are running and when you aren't running. Last, stretch your calf muscles regularly, and do strengthening exercises for the midfoot such as toe curling and picking up a small towel off the floor with your toes. Heel spurs are closely related to plantar fasciitis. This last structural issue is more common than you might think.
Our bodies are designed to accommodate injury wherever it occurs. Sometimes this means a shift in how we use our feet, even far away from the injury. Poor movement, or exercising on unforgiving terrain that causes you to shift your gait, can also lead to heel pain after running.
Runners with weak bones in the feet may experience undetected small fractures that shift their movement slightly. This slight movement adds up when running and hiking or even walking long distances. Falling into the category of poor movement is also excessive movement. Even the most dedicated athletes require cycles of activity and rest. If you are not allowing your body periods of rest and recovery, especially after intense activity, your feet will surely let you know.
Finally, where we run or hike matters when it comes to keeping our feet healthy and strong. Running over rocky, uneven terrain or only sticking to hard, unforgiving pavement can lead to heel pain when running. There are other causes of heel pain after running that are less common but can occur. These include:. Running or other vigorous exercise may not cause these conditions, but their presence can contribute to pain afterwards. For mild heel pain after running or heel pain after hiking , the best treatment is really an ounce of prevention.
The first step starts with the basics. Selecting and fitting the best shoes for plantar fasciitis prevention is crucial. If you are an avid runner or hiker, take the time and spend the money to go to a shoe store that specializes in properly fitting shoes for exercise.
They will analyze your gait and offer several options so you can find the most supportive and comfortable shoes possible.
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