What Causes Heel Pain?

Heel pain is one of the more common running injuries seen at the San Diego Running institute. The runner often complains they have pain in their heel or arch that is worse in the morning and gradually “warms up”. They also say that the pain gets progressively worse as they “run through it” and following running the pain is so bad it causes them to limp. It is surprising how many of these runners with heel and/or arch pain have been misdiagnosed, given bad advice and ineffectual treatment. Heel pain can be

  • Plantar Fasciitis
  • Heel Spurs
  • Stress Fracture
  • Joggers Foot

How would I know what is causing my heel Pain based on my Symptoms?

  • Plantar Fasciitis – Early symptoms of Plantar Fasciitis are pain in the morning when getting out of bed that gradually warms up.  Pain after a run that begins after you drive home and get out of your car.  Pain after sitting for a period of time at work.  There is usually minimal or no pain while running, walking or hiking.
  • Heel Spur – Symptoms can begin very much like Plantar Fasciitis except the pain is present throughout the day and will typically get worse or not warm up with prolonged running, walking, hiking or standing.  Heel pain caused by Heel Spurs or Heel Spur Syndrome must be treated differently than Plantar Fasciitis.
  • Stress Fracture – A Stress Fracture of your heel bone (Calcaneus) will cause constant heel pain with standing, walking, running or hiking.  While an X-ray cannot see a heel stress fracture it can see a Heel Spur which allows differentiation of the two conditions.
  • Joggers Foot – Is a nerve entrapment condition similar to Carpal Tunnel Syndrome of the wrist.  In this case the medial branch of the Calcaneal nerve gets trapped and compressed beneath the medial retinaculum causing constant burning sensation near the heel.

How do I Fix Heel Pain?

The Fix depends on the diagnosis.  Accurate diagnosis is necessary for effective treatment.  If you have heel spurs or Heel Spur Syndrome and are diagnosed with Plantar Fasciitis the treatments will be ineffective.

  • Fix Plantar Fasciitis.  If your Heel Pain is being caused by Plantar Fasciitis there are simple home remedies you can use.  Stretching, Strassburg Sock and self massage using a Theraband foot roller are the easiest and most effective home remedies.  Ineffective home remedies for Plantar Fasciitis are ice, strengthening and uncomfortable orthotics.  If you have tried home remedies are not not getting enough relief it is possible you do not have Plantar Fasciitis and have been misdiagnosed.  San Diego Running Institute has developed methods for accurate diagnosis and effective treatment for Plantar Fasciitis and can help you get rid of it once and for all.

    Strassburg Sock for Plantar Fasciitis

    Much more comfortable than a big boot

  • Fix Heel Spurs and Heel Spur Syndrome.  If you are having Heel Pain due to Heel Spurs there are less home remedies available to you.  We have found gel heel cups (under $25) and Pedag over-the counter sports orthotics (under $50) to be more effective than most patients expensive, uncomfortable custom orthotics.  Stretching, icing, strengthening are not effective when treating Heel Spurs or Heel Spur Syndrome.

    This Orthotic is less than $50 at SDRI

    This Orthotic is less than $50 at SDRI

  • Stress Fractures of the Heel.  Heel Pain caused by a Calcaneal Stress Fracture requires 6-8 weeks of non-weight bearing.  Crutches, Peg-Legs, knee scooters and wheel chairs are other effective methods for going non-weight bearing (although not practical).

    Effective but not Practical for Heel Pain

    Effective but not Practical for Heel Pain

  • Joggers Foot.  The Heel Pain caused by Joggers Foot is due to an entrapped nerve.  No amount of stretching, strengthening, ice, heat or massage will typically help in any significant way.  There are methods for treating it but we recommend you call the San Diego Running Institute for an appointment.

    Causes Heel Pain due to an entrapped nerve

    Causes Heel Pain due to an entrapped nerve

How does San Diego Running Institute Fix Heel Pain?

  • Accurate Diagnosis
  • Begin with the most conservative treatment options for the condition causing your Heel Pain.
  • Teach you proper home care for what is causing your Heel Pain.

What are some of the Treatment Options at San Diego Running Institute?

This point cannot be stressed enough.  We will only recommend treatments after we have an accurate diagnosis.  It is our experience that often what you don’t do can be as important as what you do to fix your Heel Pain.  For example: many patients have received expensive, hard, uncomfortable custom orthotics that either did not help or even made their Heel Pain worse.  With a simple and effective modification to the orthotic we can turn an ineffective uncomfortable orthotic into a comfortable and effective orthotic.  Another good example: A patient has been diagnosed with Plantar Fasciitis and told to stretch aggressively.  They are doing it diligently but it is either not working or even aggravating their Heel Pain.  By stopping the stretching routine on our recommendation they start to improve!  These are just two common examples of incorrect diagnosis leading to improper treatment for Heel Pain.  Other treatments offered at San Diego Running Institute for Heel Pain are