As the London Marathon draws near, the excitement among runners is tangible. However, with the heightened training intensity, the risk of injuries, particularly heel pain, becomes more prevalent. In this post, I’ll delve into the top four culprits behind heel pain in runners, that I am diagnosing with increasing frequency: Plantar Fasciitis, Stress Fracture of the Calcaneus, Insertional Achilles Enthesopathy (Haglund Syndrome), and Non-Insertional Achilles Tendinopathy. Understanding these causes and their symptoms is crucial for both prevention and early intervention.

1. Plantar Fasciitis:

Plantar fasciitis is a common ailment that results from inflammation of the plantar fascia, a thick band of tissue connecting the heel to the toes. Runners experiencing plantar fasciitis often complain of sharp pain near the bottom of the heel and the instep, particularly in the morning or after prolonged periods of inactivity.

Self-Diagnosis Tips:

• Sharp heel pain, especially in the morning.
• Tenderness along the bottom of the foot and the instep.
• Increased pain after long runs or extended periods of standing.

What You Can Do:

• Stretching exercises for the Achilles and calf muscles.
• Icing the affected area.
• Supportive footwear.

2. Stress Fracture of the Calcaneus:

Stress fractures in the heel, or calcaneus, can occur due to repeated stress on the bone, commonly seen in long-distance runners. Symptoms may include localised heel pain that intensifies during activity and decreases with rest. Swelling around the heel is another giveaway. Comparing one foot to another can be helpful in demonstrating subtle swelling around the heel bone.

Self-Diagnosis Tips:

• Pain that worsens during or after running.
• Swelling or bruising on the heel.
• Tenderness to touch on both sides of the heel.

What You Can Do:

• Rest and avoiding high-impact activities.
• Gentle stretching exercises.
• Consultation with a healthcare professional for imaging.

3. Insertional Achilles Enthesopathy (Haglund Syndrome):

This condition involves inflammation where the Achilles tendon inserts into the heel bone. Runners may experience pain, swelling, and a noticeable bump at the back of the heel.

Self-Diagnosis Tips:

• Pain and swelling at the back of the heel.
• A visible bump or prominence.
• Discomfort while wearing shoes.

What You Can Do:

• Heel pads or cushions in shoes.
• Avoiding tight or rigid footwear.
• Physiotherapy for stretching and strengthening exercises.

4. Non-Insertional Achilles Tendinopathy:

Non-insertional Achilles tendinopathy affects the middle part of the Achilles tendon, causing pain and stiffness. Runners may notice pain during or after running, along with swelling and thickening of the tendon.

Self-Diagnosis Tips:

• Pain along the middle of the Achilles tendon.
• Stiffness in the morning.
• Swelling or thickening of the tendon.

What You Can Do:

• Eccentric exercises to strengthen the tendon.
• Rest and ice after running.
• Consultation with a healthcare professional for personalised advice.

 

As you gear up for the London Marathon, being aware of these common causes of heel pain is essential for your overall well-being. If you experience persistent symptoms or have concerns about your heel pain, seek professional advice promptly. Early intervention can make a significant difference in your running journey, ensuring you cross the marathon finish line with strength and resilience. Happy running!