Runner heel pain

Emily Donker (podiatrist, coach and runner)
Emily Donker (podiatrist, coach and runner)

Runner heel pain

Injuries aren’t always caused by running, even if that’s when you feel the most pain. Your everyday lifestyle and footwear (or lack thereof) contributes significantly to injury risk. Unfortunately, many people (both runners and non-runners) develop heel pain during their down time, particularly during the hot summer months when wearing thongs and being barefoot becomes almost second nature for many Australians.

Footwear choice and injury risk

When barefoot or wearing unsupportive footwear (including thongs, slides, ballet flats and many other casual shoes), the soft tissue structures within your feet and lower limbs work much harder to maintain good foot position and dampen impact forces, because there is no help from footwear.

Think about a typical day. How much time you spend wearing your running shoes or supportive shoes vs unsupportive shoes or barefoot? Balancing this to suit your foot type and strength is important in managing and preventing injuries, particularly heel pain.

Oofos thong
A better option for a thong – Oofos. Made for runners.

Many injuries cause heel pain, with Plantar Fasciopathy, Achilles injuries and fat pad injuries being the most prevalent. Each of these injuries affects a different region of the heel, so can usually be differentiated by determining the primary source of pain.

Which heel injury is holding you back?

What is Plantar Fasciitis?

ED_Image3_Plantar FasciopathyPlantar Fasciitis is one of the most common complaints addressed by podiatrists among both runners and everyday individuals. Fasciitis refers to an acute presentation, whereas Fasciosis refers to more chronic pain. Pain is typically localised to the medial plantar heel (inside of the heel) at the insertion of the plantar fascia, and sometimes also extends through the medial (inside) arch of the foot. Although the plantar fascia is a soft tissue structure, it’s very inflexible and is responsible for containing the muscles of the foot, maintaining arch integrity and stabilising the foot during both stance and gait. The plantar fascia can quite easily become strained and overworked if your footwear is offering insufficient support, because the plantar fascia is working much harder to maintain it’s function.

Plantar Fasciitis and Fasciosis respond very positively to wearing supportive footwear. Your shoes should offer a more structured arch contour and more rigidity through the midfoot. They don’t need to be over-controlling, but more rigidity will help to prevent excessive arch collapse and movement through the midfoot. Arch contour can also be beneficial for providing more proprioceptive feedback (sensitivity to foot position). Supportive thongs and enclosed shoes with an arch contouring insole are more ideal options, whilst sometimes the addition of a specific orthotic or more supportive insole will be necessary for more support.

ED_Image4_AchillesPosterior heel pain (Achilles injury)

Posterior heel pain (back of the heel) is most commonly caused by Achilles Tendinopathy and related injuries such as Achilles Bursitis. Tendinopathy is a generalised term encompassing both acute (tendonitis) and chronic (tendinosis) pain. Pain may affect the mid-potion of the tendon and/or the tendon insertion lower on the back of the heel bone. Symptoms, including the type of pain and palpable feel of the tendon, vary between these injury presentations.

The Achilles is a common tendon for the calf muscles, and is responsible for pointing the toes and pushing off the ground during walking and running gait. Compared to wearing high heels or conventional running shoes (10-12mm heel pitch), being barefoot or in flat shoes places significantly more stretch and strain on the calf muscles. There is subsequently also more strain through the Achilles tendon. Injury occurs when loading and strain is greater that what the tendon can withstand, either from inappropriate footwear choices, excessive running, or a combination of both factors.

Footwear’s role in Achilles injuries?

Tightshoes_TinglingtoesFootwear again plays a significant role in resolving Achilles injuries. Structure and support are important, but targeting shoes with a higher heel pitch (difference in height/cushioning under the foot between the heel and forefoot) is most important. Increased heel pitch will reduce strain and stretch on the calves and Achilles, and promote active recovery during every day walking and standing without excessive load. Sometimes the opposite approach can be employed.

Wearing shoes with lower heel pitch is suggested to help by passively stretching the calves and Achilles to developing strength. However, with this approach most people are more likely to suffer in the short term due to overload and increased strain. It depends how your body responds. The most suitable approach will be dependent on your specific symptoms and injury presentation.

Plantar heel pain (fat pad injuries)

Injury of the fat padPlantar heel pain (underneath the central heel) can be caused by a number of injuries, with most being related to the calcaneal (heel) Fat Pad. The fat pad is designed to dampen impact forces and work as the body’s self-defence cushioning system. Fat Pad injury causes structural damage and jeopardises function, meaning that the heel bone is subjected to much larger impact forces in stance and during gait. Contusion (partial damage) or complete rupture may occur, with the later typically resulting from a sudden traumatic event such as landing very heavily (usually from a significant height) on a hard surface. Excessive load on the fat pad from long periods of standing or repetitive landings on an unforgiving surface can lead to contusion, particularly if footwear is not providing additional protection.

Fat pad injuries respond best to plenty of cushioning underneath the foot, so again barefoot and unsupportive footwear should be avoided. Your shoes are required to work for the fat pad and prevent excessive force to the heel. Having a structured heel counter can also be beneficial in helping to contain the fat pad soft tissue underneath the heel.

IRIC17_RehabLogoV2So how do you avoid runner heel pain?

Whilst the presentation and treatment required for each of these injuries is different, wearing more sensible and supportive footwear is an essential part of the treatment plan. Being barefoot or wearing unsupportive shoes can be a primary contributor to injury in each case, so whether you’re trying to prevent injury or resolve heel pain, think about your footwear choices and make changes to ensure you are comfortable in your running shoes and your everyday shoes.

If you need assistance to overcome your heel pain, or would like footwear advice, click the button below to book an appointment with a podiatrist at intraining Running Injury Clinic.

Make appointment

Love2Run – June17 e news


intraining’s Love 2 Run e-News – June 2017

The Gold Coast Marathon is almost here! There will be runners who are fitter than ever, others longing for a return to running after injury and some who are content to keep building fitness with other goals such as Brisbane Marathon Festival and Twilight Bay Run ahead. Whichever boat you sit in, we hope you are enjoying your running so far this season.

This month’s edition of Love 2 Run enews focuses pre-event nutrition, mid season running injuries as well as keeping up with the latest in trendy running gear.

We love running at intraining, whether you are keen to find out if your shoes are ready for replacement, have an injury that just won’t go away or you just want to have a chat about your running – we are here 7 days a week.

In this this issue:
Nike Zoom Fly: The fastest shoe in the world has arrived #breaking2
Sore heel? Need help?: Introducing the new runners’ wonder sock
Calf injuries and you: Pain in the calf holding you back?…here’s why.
Pre-event nutrition tips: Nail your nutrition before race day.
Brisbane Marathon Festival: Commit now before the Friday price rise
Twilight Bay Run: The event (singlets) that stopped the nation.

Did you know running facts – Part 5
Keep hydrated and fuel your performanceDehydration greater than 2% of your body weight may result in a decline in performance, which may have a negative effect on the intensity of your race and training sessions. The average person will sweat approximately 1.4L per hour of running. How much do you sweat?

What should you do to stay hydrated?
– Drink to thirst – when you are thirsty make sure you drink before and during the race
– Drink little and often – avoid consuming large volumes of fluid throughout the race
– Measuring body weight before and after a training session, will give you a guide to how much fluid you lose in sweat (for a given environmental and exercising condition).

Stay healthy, keep active and have a happy run!

#Breaking2 – We have the NEW Nike Zoom Fly available
Your PB is just a pair of shoes away!
First there was the sub four minute mile barrier, which seemed impossible. Today, there is the seeminly impossible sub two hour marathon mark. The solution… a new shoe developed by Nike with the claim of a 4% improvement in time.

We have recently received the latest #breaking2 inspired Nike Zoom Fly in store. The unique fit and feel of the shoe is unlike anything we have experienced. In our initial testing, it feels as though you float along the ground with less effort. It almost feels like the shoe is pushing you forward or like you are running with a tailwind. Whilst the shoe is lightweight, the cushioning is to the contrary. This shoe feels as comfortable as a training shoe with all the benefits of a racing shoe.

When you have done all the training and you are looking for that little extra edge, the new Nike Zoom Fly may be your ticket to that personal best time. Available in both male and female sizing at the intraining Running Centre.

Keen to give them a go? Ready to experience effortless running? Drop by the store and see if the new Nike Zoom Fly has what it takes to propel you towards your goal at your next event.

Remember, as with all shoe purchases at intraining Running Centre, our trained footwear specialists will analyse your running gait to ensure you put your best foot forward.

Nike Zoom Fly - #breaking2 inspired - Available at intraining Running Centre

Feetures – The new wonder sock is here
Sore heel holding you back? This sock can help
Ever had that frustrating feeling when you wake up in the morning and find out you have a sore heel? Plantar fasciitis (PF) is a condition caused by drastic or sudden increases in mileage, poor foot structure, and inappropriate running shoes, which can overload the plantar fascia, the connective tissue that runs from the heel to the base of the toes, resulting in heel pain. If you have every had PF, chances are you know it can be a real pain to overcome.

Enter the new Plantar Fascia compression sock from Feetures. This is the latest high-quality recovery focused foot garment to hit the shelves at intraining Running Centre. Whilst not the silver bullet in curing plantar fascia pain, they’re a great adjunct treatment for sufferers of Plantar Fasciopathy. Read more here how the new wonder sock can help provide relief and get you back out running quicker.

The Plantar Fascia Compression Socks from Feetures have recently been launched worldwide. We are excited that intraining Running Centre is one of the first few locations you can get your hands on a pair … well, your feet in a pair!

Feetures PF sock- available at intraining Running Centre

Calf injuries – Doug James (podiatrist, physiotherapist & runner)
Find out the how and why of your calf concerns
There are few things more frustrating than spending months training for a race, only for an injury to prevent you from being able to run it. Calf and lower leg injuries are responsible for a good number of these ‘DNS’ (Did Not Start) type injuries, but many of them are preventable.

Your calf muscles and lower legs are like barometers for how well you are handling your training load. Pain and muscle tightness are often signs of overuse and may signal an oncoming injury. The biggest cause of running injuries are errors in your training approach.

At this point of the season errors may be due to not allowing sufficient recovery time between hard sessions, and failing to heed warnings that you are pushing too hard.

Optimal performance comes from finding…read the full article here.

Calf Injury - Read article by Doug James (podiatrist, physiotherapist and runner)

‘From the Sole’ articles are written by our intraining Running Injury Clinic podiatry, physiotherapy, dietitian , massage therapy  and coaching team.

Make an appointment to see one of our clinicians who can assist with diagnosing and treating your running related injury.

Pre-event nutrition – Liz Lovering – (dietitian, cheft and runner)
Optimise your pre event nutrition to get the best result
Although there is no one ‘best’ food to have pre-event, type and timing is important.  Everyone is different in what they prefer to have before they race. But, in general, your pre-event meal or snack should be rich in carbohydrate, low in fibre, (important if you have issues with gut upset), easy to digest (higher fat foods digest at a slower rate) and most importantly familiar.

Runner nutrition - Nail your next racePre-event nutrition must be practiced in training. This is so you can find out what works best for you. You need to allow adequate time for digestion. It can take anything from 2-4 hours to digest a full meal so if your event starts early in the morning, rather than impact on sleep, have a carb rich snack before bed and in the morning a read the full article here in this months issue of ‘From the Sole‘.

If you are keen to nail your next big event, your nutrition strategy can play a big part in your result. Maximise your performance and make an appointment to see intraining dietitian and nutritionist, Liz Lovering.

(health fund rebates available with minimal out of pocket expense)

Brisbane Marathon Festival 2017
News just in – Early bird entry extended!
Good news for all of those participating at the Gold Coast Marathon this weekend. Enjoy your event this weekend and rest easy that you can still save on your Brisbane entry until Friday 7th July. We have just received word from Brisbane Marathon that early bird entry fees have been extended.


The new course for the 26th annual Brisbane Marathon Festival has been announced. Featuring a flatter and faster course in 2017, designed for to achieve your PB goals this running season. Check it out here.

Set your sights on completing the full or half marathon, 10km, 5km and let the kids loose in the NEW 1km Mini Marathon.

Click here

FREE Brisbane Marathon training group at intraining Milton store - 6pm Wednesdays

Twilight Bay Run – Saturday 23 September 2017
Ever run at night…with fireworks over head?
Make sure you get your entry in for one of the most exciting events of the year at Twilight Bay Run. The very special super early bird rate increases at midnight tonight.


If you have not experienced a run under the moon and stars, now is the time to get your entry in for the 6th annual Twilight Bay Run in Wynnum. Forget the early morning wakeup and get ready to stride it out under the stars on Saturday 23rd September. Featuring, half marathon, 10km run/walk, 5km run/walk and 1km kids event this is one for the whole family to enjoy.

Click here

Join in the fun at Twilight Bay Run - Saturday 23 September

Pain in the heel?

Pain in the heel becoming a pain in the butt?

Feetures_PFsockLet’s face it, having a pain in the heel is a huge pain in the butt. Plantar Fasciopathy and/or Fasciitis is a prevalent injury amongst runners and the general public alike. Plantar Fasciopathy causes significant and often debilitating pain that affects not only running, but everyday life. Most often pain is experienced in the heel, but it can also extend through the medial arch of the foot.

Enter the new Plantar Fascia compression sock from Feetures. This is the latest high-quality recovery focused foot garment to hit the shelves at intraining Running Centre. Whilst not the silver bullet in curing plantar fascia pain, they’re a great adjunct treatment for sufferers of Plantar Fasciopathy. The Feetures sock assists in relieving tension through the plantar fascia and providing lasting support and symptomatic relief.

Three key areas the Feetures PF sock can help

  1. Eases heel and arch pain
  2. Targeted compression lifts, stretches and stabilizes the plantar fascia and supports the Achilles tendon
  3. Easy to wear sock provides convenient relief

If you are looking for a compression sock that will assist in your recovery process and help reduce the pain in your heel, these are worth a try. Not only will they offer Plantar Fasciitis sufferers in managing pain, the socks provide fantastic comfort and can be worn both during and after running.

Article by Emily Donker. Podiatrist, coach and runner
Article by Emily Donker.
Podiatrist, coach and runner

The Plantar Fascia Compression Socks from Feetures have recently been launched worldwide. We are excited that intraining Running Centre is one of the first few locations you can get your hands on a pair … well, your feet in a pair!