Learn the best ways to deal with two of the most common running-related injuries - plantar fasciitis and heel spurs.
The two most common injuries that can cause heel pain in runners are plantar fasciitis and heel spurs. In fact, plantar fasciitis (PF) is one of the most common of all running injuries. PF and heel spurs are very similar in their symptoms, causes and remedies. Unfortunately, they are difficult to get over, and take time to completely conquer. However, they can be overcome. What’s more, as long as the pain is not severe, you may still be able to continue running and training even while you have one of these injuries.
Although I don’t recommend this to any of you, I trained for and raced in my first two marathons with PF. Thankfully, my PF was not as severe as some people’s. I also tried everything I could come up with to help with the problem, including icing, massage, night splints, taping, stretching, exercises, physical therapy and orthotics, and most of this probably enabled me to run the two marathons, in spite of the injury. As I said, though, I don’t recommend this. It is much better to get over the injury as quickly as you can, then slowly build up to whatever your next goal is. For other foot injury problems you can use these links to find information about injuries affecting the tops of your feet, your toes and toe nails, or general injuries such as blisters and corns.
PF pain is usually on the heel and along the arch. The pain tends to be worst first thing in the morning when you get out of bed. Those first few steps can feel like someone is pounding a nail into your heels. A similar pain can be experienced when you stand up after sitting for hours at a time. If you press hard on the middle of your heel with your thumb, and it hurts, you’ve got PF. If this action doesn’t cause much pain you may, instead, have heel spurs (see below).
Fascia is a type of connective tissue, in this case connecting the heel to the ball of the foot. In PF, this fascia becomes injured and inflamed (swollen). PF is aggravated by running too much or too hard, or running with too little cushion. It is often difficult to pinpoint a single cause of this injury, as it tends to build up slowly over time, but a number of causes contribute to the injury – sudden change or increase in running, no arch support, tight calves, being overweight, other injuries, too little cushion in your running shoes, running on hard surfaces too often, inflexible running shoes, and spending too much time on your feet.
There are a number of things you can do to help with PF. Rest is critical. Back off of the mileage. You shouldn’t stop all running or other activities. Just back off to a level of running that is easy for you to handle.
Ice is a key component in recovery of all soft-tissue injuries, PF included. I recommend two different ways of icing your foot. The first is to simply place the foot on top of an ice bag or bag of frozen peas while sitting. Do this for no more than ten minutes at a time, as the direct contact with an ice bag can be harmful to the skin. If you are concerned you can keep a towel between the foot and the ice. I found that, after months of icing my foot I became quite acclimated to the whole thing so that I hardly noticed the coldness at all. The other way to ice your foot is to freeze a bottle of water, and the roll the bottle back and forth under your foot for 10-15 minutes. This is a great way to ice the foot as it combines massage and ice. However, it requires a lot more concentration as the bottle has to be readjusted frequently to keep it under your foot.
Stretching the calf muscles, is another important component of PF recovery. This is because tight calves is one of the main contributors to PF. Stretch the calves several times a day, morning, noon, night, and times in between. In fact, the best thing to do is to stretch the calves for a few minutes while still in bed each morning. This should prevent most of the “first step pain”, and can have a significant impact on the injury.
Along with stretching the calves is keeping the feet in a flexed position at night. I highly recommend purchasing a nigh split. A night splint is something you wear on your foot while you are sleeping that keeps your foot flexed and the calf stretched all night long. It does take some getting used to, but I believe that it is essential in getting over PF. In my experience the best type of night splint is an open-air boot that is inflexible and holds on to your foot and leg in multiple different ways in order to prevent the foot from relaxing into a toe-pointed position. I bought my original night splint for about $40 several years ago, but there are a number of them on Amazon.Com for much less and that are much better quality.
Heel spurs have similar symptoms to PF, but are not exactly the same thing. Like with PF, the pain is mostly in the heel and the arch, and is worst first thing in the morning. Unlike with PF, however, you will feel the pain when you press at the front of the heel where it intersects with the arch, rather than at the middle of the heel. The heel spur is a calcified deposit that forms against the heel bone. The pain is not the spur itself, but the flesh and fascia around the spur.
The downside is that you can’t do much to remove heel spurs on your own, but you can alleviate some of the symptoms through icing, wearing heel pads or arch supports. However, your podiatrist can help. They may prescribe orthotics, which should take care of the problem permanently. They may also prescribe surgery to remove the spurs, which is successful, but you may still need to wear orthotics anyway, so only do surgery as a last resort.
Plantar Fasciitis and heel spurs are the two most common injuries runners experience in the heel area. Both have similar causes, and both are treatable. The best solution is to use several different methods in tandem – icing, stretching, night splints, orthotics, massage, and backing off the training somewhat. For other foot injury problems you can use these links to find information about injuries affecting the tops of your feet, your toes and toe nails, or general injuries such as blisters and corns.