Protect Your Heels!
by Melinda Burris

This article discusses common heel-related injuries—their causes and how you can avoid them, as well as treatments if you do develop these conditions.

1. Plantar fasciitis: The plantar fascia is a band of non-elastic fibrous tissue that runs along the bottom of the foot and is attached to the heel bone. The plantar fascia spreads out to the metatarsals (bones that connect the ankle to the ball of the foot). Your body relies on tension in the plantar fascia to preserve the arch in the foot.¹

Plantar fasciitis frequently involves an injury to the heel. This injury often proves painful as it causes the arch of the foot to have inadequate support, causing the arch to fall during pronation. This means the foot absorbs shock each time the foot hits the ground as you walk or run.¹

Causes: Athletes are prone to develop this condition if they fail to train properly. Some instances include failure to do adequate stretching and other warmup activities prior to beginning a run, workout session, or competition. Excessive training on hard or rugged surfaces can lead to the development of plantar fasciitis as can the use of spiked shoes too early or too often. Increasing the pace or distance of your running time too quickly can also lead to plantar fasciitis. *You may be genetically predisposed to developing this condition if you are born with flat feet or very high arches.¹

Symptoms: It is common for those with plantar fasciitis to experience pain when they first step out of bed in the morning as the area stiffens up overnight. Plantar fasciitis is often characterized by abnormal gait or stride patterns and pain when running or jumping.¹

Preventative Measures: Do proper warmups before you begin running. Make sure you wear shoes that give your feet proper cushion and support. Change up the surfaces you run on. For example, give your feet a break from hard surfaces like pavement and run on flat, grassy areas that are softer and don’t shock the feet as much. Heed advice from your coach or trainer about when is the proper time to wear spikes and how often you should wear them.¹ Overwearing spikes can lead to a case of plantar fasciitis, as can wearing them before you have learned to maintain a foot strike that consistently lands on the ball of the foot.

Treatment: In its early stages this condition can be treated by using nonsteroidal anti-inflammatory drugs such as Ibuprofen. You should also apply ice to the foot to aid in the reduction of swelling. The use of heel inserts and splints may also be beneficial. After the first week of treatment, you will want to stop applying ice and apply warm heat followed by massage and a series of gentle range of motion exercises.¹

If you experience pain when getting out of bed in the mornings, try applying a heating pad under the calf muscles to relieve tension and get your circulation going before you take that first step. Wearing proper footwear that provides adequate arch support and refraining from any activities that cause the pain to worsen is vital to recovery.  Depending on the severity of your case, you may find wearing orthotic inserts or shoes helpful. Recovery times vary depending on the individual and the severity of the injury, but the condition will usually clear up in 6 weeks – 6 months.¹

2. Achilles tendonitis: This injury is caused by overuse of the Achilles tendon, which is a band of tissue that connects the calf muscles located at the back of the lower leg to the heel bone.²

Causes: This overuse injury is frequently seen in runners who increase the pace or duration of their run times too quickly. It also occurs quite often in middle-aged people who participate in sports primarily on weekends as the Achilles tendon weakens as we age.²

Achilles tendinitis occurs when the Achilles tendon is used too repetitively or if too much strain is placed upon it. Overuse can easily occur if you are not careful because this tendon is used for every motion your feet make from walking, running, or jumping to performing a plantar flexion motion to point the toes or stand on the tips of them.²

Several genetic risk factors can make you prone to developing Achilles tendinitis. For instance, men are more likely to experience this condition than women. If you are flat-footed, the Achilles tendon is put under more strain to lift your foot and perform a motion.²

Running and jumping in shoes that do not provide adequate support for the arches and the foot as a whole can cause this condition.

Symptoms: Typically, Achilles tendinitis presents as a mild ache either at the lower back of the leg or just above the heel after running, sprinting, or any other repetitive motion such as stair climbing.² 

Preventative measures: This condition is also characterized by morning stiffness or irritability. Generally, the pain improves once you do mild activity or range of motion exercises to relieve tension and stiffness. If you are prone to Achilles tendonitis, be aware that cold weather can aggravate this condition. Running on rugged or uneven surfaces can predispose you to this condition so opt for a smooth running surface. Avoid overuse by changing up your training sessions so you aren’t constantly repeating the same motion.²

Treatment: Doing proper stretching before exertion and working to strengthen your calf muscles will help alleviate and prevent the reoccurrence of this condition. You may also try taking an over-the-counter anti-inflammatory medication such as Motrin to treat the pain. *Achilles tendonitis must be taken seriously as left untreated, it can make you more susceptible to tearing a tendon which may require surgery.²

3. Chronic heel soreness: Unlike the ailments discussed above, heel soreness is a symptom that can be caused by a variety of conditions based on age and your training regimen.

Causes for young athletes: Although overuse injuries can occur at any time in life, according to the Colorado Center for Podiatric Sports Medicine, for young kids Sever’s disease or calcaneal apophysitis is the most frequent cause of heel pain. This occurs while children are still growing until they reach skeletal maturity. (This occurs between the ages of 14-17 in girls and between the ages of 18-22 in boys.)

Causes for adults: Plantar fasciitis and Achilles tendonitis are among the most common causes of heel pain. Stress fractures, bone spurs, and bursitis are other frequent causes of chronic heel soreness.

Symptoms: Chronic ache or soreness in the heel of the foot.

Preventative measures: Always wear properly fitting shoes that give your feet the correct support. Always do warmup exercises before a training session or going for a run.

Treatment: This can vary depending on the root cause of your heel pain. Treatment can range from using heel guards or orthotics to taking a mild pain reliever.

Takeaways

Prevention really is worth a pound of cure! Treat your feet well and they will return the favor! Be patient; don’t rush to increase your running speed or distance until you are ready to do so. Wear the proper shoes that give your feet the correct support to ensure you can give your best performance, free of pain.

References:

1. Walker, B. (25 May 2020). What is Plantar Fasciitis? Discover what causes plantar fasciitis and how to treat it.
2. Mayo Clinic. (1998-2023). Achilles tendonitis.
3. Colorado Center for Podiatric Sports Medicine. (n.d.). Heel Soreness.