If you're here with me on this video, I know that you love to run. But if you haven't seen this show before, it's called Runner's High. I'm Jesse Funk and on today's episode of Runner's High, we're going to talk about where exactly your heel pain is coming from.
Anytime you want to go run, and you've got a problem with your feet going on, be it pain, irritation, itching, whatever it is, it’s a problem you simply can't ignore because your feet are so involved in what you're doing. Having worked at a shoe store full time for three years, I saw all numbers of problems with people's feet. That's kind of what we specialized in.
But you have to remember that there are 26 bones and all of the connections in your feet. So, it's not unusual for something to go wrong. There's a lot going on with your feet and that's 26 bones per foot by the way. Not just one foot and the other.
Heel pain itself, I would typically break down into four major categories. And I'm going to list them in order of most common to least common. So, you will probably drop off as the video goes on as I kind of describe what's going on with you and you say, okay, that's probably it. But stay with me to the end just in case and we will probably cover what's going on with you.
As always, I am not a licensed physician. I am friends with some, but that does not give me credentials to diagnose. So, remember, I'm giving you general information. A doctor or a sports physician is always going to be your best bet to diagnose you and give you a specific recipe for treatment.
The number one most common ailment that gives you heel pain from running is gotta be plantar fasciitis, hands down. This is what happens to a large majority of people that have heel pain. Now you can get plantar fasciitis from a number of predicaments that you find yourself in. You're wearing bad shoes or worn-out shoes, you're running on too hard surfaces, you're increasing your mileage too fast, you aren't stretching enough. All of these things and even combinations thereof can present problems and create a situation where you have plantar fasciitis.
Now, what's actually happening here is there is a sheath that surrounds the muscles in your feet. When this sheath begins to pull away from those muscles, you get pain. As you imagine pain is your body's signal that something's going wrong. So, plantar fasciitis is basically your body's signaling to you, “Hey, this is wrong. This sheath is supposed to be covering these muscles, it's supposed to be getting torn or pulled away. Something is wrong, please fix it.”
Now, if you look at your foot here, and you go towards your heel, your plantar fascia and the surrounding muscles attach about here in this area. So, when you get that heel pain, and it starts in that area near your arch and goes back into your heel, then that is a good signal that you probably have plantar fasciitis.
If you've ever had plantar fasciitis before, you know that it can be a super pain to get rid of for a lot of people. But much like I mentioned in the beginning, you basically have to counteract all those things that are causing you problems.
So, if you have bad shoes, you need to get new shoes and get shoes that actually fit you and are for your foot and mileage activity. If you're on hard surfaces, like in my case, I'm often running on a sidewalk, there are grass patches I can be running on. So, if you need to hop on the grass, stay off of the sidewalk as much as you can.
As a side note, asphalt is typically softer than the cement on the sidewalk, if it's possible. I know I live in an area with a lot of car traffic that likes to ignore pedestrians so that's not possible around here. But if you live in an area where you can, being on the street is going to be softer than the sidewalk if you have to choose between the two and there's no grass available.
Whatever it is that you have to do, you have to take some course of action to treat it. Massage helps. I particularly like ice massage with a product called cryo cups. As I talk with Christie Aschwanden in my episode with her on the Smart Athlete Podcast. She is so-so on how effective icing is in everything, but it's my just personal experience with plantar fasciitis over the number of years I've been running, that it was helpful.
There are a number of I'll say devices that help you with plantar fasciitis. But I don't think they're really necessary until you get to the point that the basic things don't work. And before you go to those devices, I would also probably look at some kind of over the counter orthotic or arch support as a way to help relieve the pressure on that arch, that underneath section of your foot. fascia is so that it has the time and energy to heal even while you continue to run.
The number two problem here is often in conjunction with or confused with plantar fasciitis, and that's Achilles tendonitis. And really I'm going to cover two conditions with your Achilles tendon, not just Achilles tendonitis. Achilles tendonitis is really more of an overuse injury and that's with your Achilles tendon here on the back of your foot.
Now, when you have this issue, really the only solution is to back off of the volume that you've been doing to give your Achilles tendon a break. The other potential problem with your Achilles tendon is that you had strained it or sprained it, and this is an acute injury.
So, conversely, to Achilles tendonitis, which happens over time from overuse, or increasing mileage too quickly; this is something that's going to happen in a snap kind of incident where you've sprained it. And that's you could be tripping in a hole or any kind of thing like that is an acute injury. And if that presents pain in your Achilles tendon, then you probably have some kind of strain or sprain. And again, the only thing you can really do is stay off of it.
So, it's kind of a bummer either way that you have to pull back, but also know that it's one way your body signals to you, hey, you're going too fast. When you build up mileage and something goes wrong. That is your body's cue to say, okay, enough is enough. We're going to make you stop even though you don't want us to. So, keep those in mind as you're training.
The next two, I'm going to give you much less common, but if I haven't covered your issue so far, the next two will probably do it. Our third problem here as I said, less common is heel spurs. Now, heel spurs are a calcium buildup on your heel. So, it's actually kind of attached to your bone. They typically resolve naturally for the vast majority of people, 90 plus percent of people buy those typical methods that we use to resolve everything; stretching, massage, ice, antiinflammatories. Now, it's because of that calcium buildup or a bump on that heel, that you may be getting some rubbing on the tendons and the muscles in that area and getting pain.
There are a few people that end up having to have surgical intervention. And typically this is because they don't resolve on their own, or they're growing too large. And recovery from surgery is pretty straightforward. And as far as I know, pretty effective as well. Again, with this one, and the last one, you're going to need a doctor to help figure out this is exactly what's going on and what's the best course of treatment. The first two you can kind of self diagnose, these last two, not so much.
And our last thing that gives you heel pain of the four most common things is going to be a stress fracture. This doesn't happen very often for most people, but it is definitely a case of overuse. All four of these can be the case of overuse. But stress fractures, in particular, are going to be a case of overuse injury. You're putting too much time, too much pounding on those bones. Sorry, not your muscles on your bones, and then it's causing micro fractures in the bone itself.
So, as I mentioned in another video talking about stress fractures, there's a DIY way to diagnose yourself with a stress fracture. And that is with a tuning fork. Use a tuning fork, ding it, put it up against where it hurts. If that makes it hurt, then you almost definitely have a stress fracture. However, it not hurting is not conclusive that you don't have a stress fracture. There's kind of an escalating step of diagnosing stress fractures. It starts with a tuning fork, you can use an ultrasound machine, basically the same effect. We're trying to rattle little fragments of bone inside there if they are there because there's a fracture. If it produces pain, again, a signal you probably have a stress fracture. Those are kind of the two field ways for trainers to diagnose.
The more official ways and this is, as I mentioned, where you need a doctor is an X-ray, and then most conclusively an MRI. Obviously, expense goes up as you go up that scale, but so does accuracy and the people looking at it, their kind of knowledge to diagnose what's going on. So, those are my four things that are causing heel pain. If those don't do for you, and you figure out what's happening with you, let me know down in the comments below. Maybe you can help somebody else out that's having keel pain and it wasn't covered by my video. I'll see you next time on the next episode of Runner's High.