Heel Pain Uncovered!

It’s those dreaded first few steps in the morning, where it feels like you’ve either stepped on glass or been smashed in the heel by a mallet. The symptoms are predictable- give yourself a couple of minutes and the pain subsides, you go on with your day forgetting about the glaring issue, hoping against anything that it miraculously decides to give you a break tomorrow morning.

The fact that the pain subsides quite quickly, fools most people into ignoring the issue, deciding that it obviously can’t be too serious. However I’m hoping this article sheds some light and allows our community to address these symptoms in their infancy before it really affects their training.

To differentiate, plantar fascia pain is experienced on the bottom of the foot and can be located anywhere from the heel to ball of the foot. Conversely, achilles tendon pain will be at the back of the leg from the heel, all the way up the tendon to where the bulk of the muscle belly begins. Regardless of which site you experience pain, the root cause is one of the following (or a combination)

● Training load (running, skipping, jumping) ramping up in volume at a pace quicker than the body can recover from.

● Maintaining training load but having poorer recovery (eg less sleep due to work stress, sick kids, new borns, or a recent illness where nutrition has been affected)

● A previous lower back injury where you’ve had nerve pain down the leg

I could write a whole essay on the importance of mechanics dictating how much volume a person or tissue can tolerate, so let’s assume for the purpose of this article that you haven’t recently changed running mechanics or gone from a conventional training shoe to a more minimalist shoe.

How to fix the issue:

The important variables are:

● Unload the affected tissue for a couple of days (no more than a couple). For plantar fascia and achilles that means drop the running, skipping, jumping, calf stretching.

● Promote blood flow- an irritated tendon requires blood flow to begin the repair process. This could be deep heat, heat packs, easy work on the bike, rolling a massage ball over the ball of the foot (keep the massage as comfortable as possible rather than painful).

● For the plantar fascia, the successful treatments I’ve found are:

1) Calf Raises on the Fascitis Fighter

https://youtube.com/shorts/8HkLywqpfxo?si=3rNvXiHwp5WeOd70

2) Toe Extensor Stretch

https://www.youtube.com/watch?si=-ias2Np87tSbA8Yp&v=h2kaEOd3GcI&feature=youtu.be

These strategies address different things- the calf raises address the tissue capacity angle, whereas the toe extensor stretch improves the length- tension relationship.

● For the achilles tendon, we need to induce a stimulus that will allow for greater collagen repair/re-generation at the site of pain. I use a 3-tiered approach.

1) Begin with calf raise isometrics (4x45 seconds)

Once that’s too easy-

2) Perform Calf raises (feet flat on floor- not off stairs and not using the fasciitis fighter) in a 2 up/ affected leg down (3x15)

3) Progress to single leg calf raises (3x15-20)

If there’s one take-away message from this- as soon as you experience some morning discomfort taking those first few steps, let one of the coaches know so that we can recommend what to do next and adjust any workouts as necessary.

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