Pain arises in the centre of the heel and sometimes can spread to the arch region of the foot. Some patients complain of intense pain when walking the first few steps in the morning and after periods of rest.
The most common cause of heel pain is plantar fascitis. The plantar fascia is a broad band of tissue that runs along the bottom of the foot. When this band of tissue is damaged due to biomechanical reasons or inappropriate running shoes then the tissue can become inflamed or even tear at the heel bone. This can be very painful and can result in a total cessation of runningt.
As stated above, if biomechanical complaints such as over pronation exist during running then this can lead to planter fascitis. Over pronation occurs when there is excessive mobility in the sab-taler joint of the foot which causes hyper mobility of the foot. Conditions such as flat feet can also cause over pronation. This increased mobility adversely affects all the muscles in the foot and can even affect the lower leg, upper leg and cause back pain. The mechanical imbalance is highlighted during running due to the increased forces being applied to the body
Runners often complain that the pain increases when they enter the toe off phase of the running cycle as this stretches the muscle away from the heel bone. Apart from over pronation, other causes of planter fascitis are a change of running shoes, dramatic increases in speed work, hill work and mileage.
Sprinters and marathon runners can sometimes experience a plantar fascia rupture. This occurs due to the predisposing factors accompanied with abrupt forces being applied to the heel. A runner may experience a sudden intense pain in the heel area. This will result in a non-weight bearing cast being applied to the runner for 1-3 weeks with full recovery in 12 weeks.
Initial treatment should consist of an ice pack. Some runners prefer to use a wet towel that has been in the fridge. We recommend you use commercially available ice packs for focused pain released. An anti-inflammatory such as Ibuprofen will help to reduce the swelling. Please note this should be taken with meals and never before running.
As with all soft tissue injuries, you may have to re-examine your training regime. A reduction or even a total break form running may be necessary. . Examine your running shoes, making sure the shoes do not bend excessively near the middle of the foot and at the ball of the foot. Sports shoes with built in insoles can be beneficial, however we recommend you replace existing insoles with specific sports orthotics/ insoles. Silicone heel cups, leather heel pads and contrasting cold and hot therapy can all help to speed up the healing process. The plantar fascia stretch will help to prevent the injury from occurring again. Please note that this stretch should not be done while the heel is inflamed and should only be attempted once you’re a feeling minimal or no pain from your heel.
Stand straight with your hands against a wall and your injured leg slightly behind your other leg. Keeping your heels flat on the floor, slowly bend both knees. You should feel the stretch in the lower part of your leg. Hold the stretch for 10 to 15 seconds. Repeat the stretch six to eight times. This stretching exercise may be helpful for plantar fasciitis, achilles tendonitis and calcaneal apophysitis.
The below information has been contributed by Bruce Brownlee from www.brucebrownlee.com
For soccer players, you may see more plantar fasciitis with screw-in cleats on hard ground, and also with kids playing without adequate arch support. Most coaches aren't trained to be able to recognize which problem is causal, so the usual approach is
Getting kids to stretch out their arches before getting out of bed saves a lot of pain on that first jump out of bed to the floor.
Getting arch supports into the kids walk-around running shoes helps out as well. We have the kids walking around a great deal, especially with travel teams, and somehow the average running shoe does not have a stiff enough arch. A lot of kids and coaches like arch supports, nearly anything is better than nothing.
For soccer coaches (usually overweight daddy coaches), you may see a lot more problems with sore heels from a lack of arch support. You may also see a lot of stress fractures of the sesamoid and some Taylor's bunions. A lot of the coaches are 50 pounds or more overweight, still muscular, and able to put too much pressure on the ball of the foot trying to make changes of direction that only 12 year old kids should do.
If you find players or coaches with Taylor's bunions, you might ask them if they are in adidas shoes. Most adidas shoes are cut far too narrow, and these aggravate this condition. A number of other shoe brands like Kelme or Nike offer a wider cut in the toe box. For running shoes, New Balance come in widths up to 3E or 4E.
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