Question: I started running about 3 months ago and have developed a pain in my heel which spreads into the arch of my foot. It feels quite stiff and painful when I first start running but eases off as I continue. It then gets worse again that night or the next morning. I’ve read that I may have heel spurs, is this correct?
The Sports Injury Clinic Answered: Possibly, but, the symptoms you describe sound a lot like plantar fasciitis. This is a condition which can occur in conjunction with a heel spur, or totally independantly.
The plantar fascia is a thick band of fibrous connective tissue (fascia) which runs from the heel to the forefoot and helps to shape the arch of the foot. Plantar fasciitis is a degeneration of some of the fibres close to the attachment under the heel. Other common symptoms include:
- Pain which is worst first thing in the morning or after periods of rest
- Tenderness when pressing on the heel and into the arch
- As the condition progresses pain will increase throughout the day
A heel spur is a bony growth that occurs at the attachment of the plantar fascia to the heel bone (calcaneus). A heel spur can be present with no symptoms at all. Similarly a painful heel and cases of plantar fasciitis do not always have a heel spur present.
So, my advice at this point is to treat it as plantar fasciitis and don’t worry about the possible presence of a heel spur. If after a thorough treatment programme, no improvements are made, then the possibility of a heel spur causing the pain should be investigated.
Treating plantar fasciitis is all about correcting the causes of the condition. Here is a list of common causes of plantar fasciitis in runners:
- Overpronation – Where the foot rolls in and the arch collapses as you run. This overstretches the fascia. Make sure you have the right kind of running shoes for your foot type! Get a gait analysis if you are unsure.
- Oversupination – This is the opposite of overpronation where there is a very high arch and the foot doesn’t roll in enough (sometimes called underpronation). Again – make sure you have the right running shoes!
- Inadequate support in your running shoes – Wearing running shoes which have the wrong support or that are worn out through overuse can cause plantarfasciitis. Replace running shoes every 300-400 miles (it sounds like a lot, but really isn’t that much!). Also think about your day-to-day shoes. Do they have good support ? Could you benefit from insoles?
- Tight calf muscles – Tight calf muscles are a common contributor to lots of lower leg injuries. Stretch you calf muscles regularly every day to help improve the range of motion at your ankle joint.
- Being overweight – Unfortunately this increases the impact on the foot with every step. If loosing weight was a goal for running, try a different form of exercise such as cycling.
- Training too much too soon – This is a problem which many new runners face. Try not to increase mileage by more than 10% per week.
For more information on the treatment and rehabilitation of plantar fasciitis, including initial treatment, stretches and strengthening exercises, please visit www.sportsinjuryclinic.net
