How to Run Without Heel Pain: 9 Essential Hacks

As a runner you're likely already aware of the stress and strain your favorite activity places on your body. While many runner’s face knee problems, heel pain is also very common. In this blog we’ll look at why heel pain tends to flare up in runners, what other factors make this problem more likely, and what you can do to prevent it from happening or recurring.

First, there are several different types of heel pain to consider, each with different causes.

While plantar fasciitis is the most common type of heel pain, Achilles tendonitis, and Sever’s Disease can also develop after running. The first two conditions have a lot in common and many of the same things cause them. Because of this, most of their prevention strategies are similar.

What Causes Plantar Fasciitis and Achilles Tendonitis in Runners?

Plantar fasciitis is an inflammation of the ligament that runs along the bottom of your foot called the plantar fascia. When too much stress and strain cause overpulling on this ligament it can become inflamed. Because you place seven extra pounds of pressure on your feet when you run, you're more likely to develop plantar fasciitis and Achilles tendonitis than someone who is more sedentary.

However, you may have wondered why you’ve developed this condition but your friend who runs as much as you do has not. You very likely have additional factors that put you at greater risk for developing it.

What are these factors?

• Tight calf muscles – having tight calf muscles can play in a huge role in developing plantar fasciitis. Tight calf muscles limit the movement of your feet and ankles when you run causing overpronation (feet rolling in with every step). When overpronation happens repeatedly your plantar fascia gets overstressed and inflamed.
• Faulty foot mechanics – runners with flat feet are also much more likely to overpronate when they run placing their plantar fascia at risk. In runners with high arches, weight falls on the heel and outside foot which also stresses the plantar fascia.
• Extra weight – while many people run to stay in shape, until you get in shape you might be carrying around some excess weight. That extra weight adds more stress to the plantar fascia.
• Worn out or unsupportive shoes – wearing worn out running shoes or inappropriate running shoes won’t adequately support your feet when running, causing overpronation.
• Inadequate training – using running as the only strategy for keeping your body fit for running.
• Too much training with no rest – oftentimes when runners are training for a race, they run every day and that is a mistake. Our bodies need time off to heal and that includes the plantar fascia and other structures of the foot.
• Hill running or stair climbing are more likely to cause Achilles tendonitis.
• Women runners are more prone to plantar fasciitis than men. Women who wear high heels tend to have a shortened plantar fascia or heel cord. Weight gain during pregnancy can also be a factor.

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What Causes Sever’s Disease in Runners

Sever’s disease is a common cause of heel pain in children who run. Sometime kids ages 8-15 don’t have a fully closed heel plate. When kids play soccer or run, they add additional stress to the heel bone which causes pain at the back or the bottom of the heel. Other factors that can increase the risk of Sever’s disease in young athletes are:

• Obesity
• Tight Achilles tendon
• Flat feet or high arches.

9 Tips to Prevent Heel Pain When Running

While you can’t change your foot type or your body structure, you can do specific things to reduce the effect they have on your arch and plantar fascia. To prevent heel pain when running, you have to do several things before you set out to run including:

1. Try Running Slowly When Training

Slow running can help your body adapt to the stress on your joints and ligaments, preventing foot and ankle injuries including heel pain. So what is slow running? Next time you go for a run, notice if you can still carry on a conversation. If you can, you're running slowly enough. Learn more about the benefits of slow running and how to incorporate into your training routine here!

2. Stretching

Like most runners you likely know that stretching is very important to do before and after you run. But very few people stretch enough to make much difference in a tight calf muscle. If you’ve been told you have tight calf muscles adequate stretching is essential to keep you from developing plantar fasciitis or Achilles tendonitis.

While wall stretches are the most common and easiest to do, it’s important to do them long enough to have an effect—30 secs to 1 minute. If your calf is particularly tight and has been a major cause of your heel pain in the past, you’ll need to do more than a wall stretch. I recommend using an Achilles splint at home to all of my patients with tight calf muscles.

In addition to doing traditional wall stretches before you run, it’s also important to get your body ready with Dynamic Warm-Ups.

3. Wear Inserts or Custom Orthotics

For people with mild heel pain after running, sometimes just switching out the insert that comes with your running shoes with an over-the-counter insert like Powerstep or Redi-thotics may be enough.

However, if you have moderate or severe heel pain after running you’ll need to see a podiatrist to be assessed and cast for custom orthotics. Custom orthotics are designed to fit your feet perfectly and provide the most stability when you run. Our office currently uses 3D Printed Orthotics to help our patients with heel pain. To design these orthotics we conduct a computerized gait analysis. 

Orthotics work to prevent the feet from overpronating and overstretching the plantar fascia.

4. Purchase the Right Running Shoes

Wearing worn out running shoes or running shoes that don’t supportive your feet adequately for the type of running you do can be problematic. To get the best running shoes for your feet follow these tips.

5. Get Sufficient Training and Rest

All runners need to get sufficient training and rest to prevent flare-ups of heel pain after they run. New runners need to start slowly. Don’t increase your running speed or distance by more than 10% a week. Trying taking a day off in between runs.

For kids who experience heel pain and have been diagnosed with Sever’s Disease, rest is essential for relieving pain.

6. Build in Time for Cross Training

It’s not enough to simply run to keep your body in good condition for running to prevent heel pain. It’s important to build in time for cross training to increase your flexibility, strength, and your core stability.

Pick one or two other activities that use other muscles in your body and feet such as tennis, basketball, or weights at your local gym. In addition, you could also do yoga to build strength and flexibility.

7. Tips for Running On A Treadmill

Treadmills can come with their own risks. To prevent heel pain flare-ups when running on a treadmill, read my blog, “9 Ways to Prevent Foot and Ankle Injuries When Running on A Treadmill.”

8. Avoid Hills

If you’ve developed Achilles tendonitis from running, it’s important to avoid hills and stairs to prevent a flare-up.

9. Weight Loss

Extra weight adds pressure to the plantar fascia every time you walk or run. Losing weight is another preventive measure for reducing your risk for heel pain after running. 

10. Low Impact Running

Research has shown that when runners increase the number of steps they take by just 5% and keep their speed the same they can reduce the impact on their body by 20% and reduce injuries. You can accomplish this by:

• Taking shorter, quicker strides
• Thinking about running more softly and quietly when you're running
• Landing on your mid or forefoot instead of the heel (Video on low impact running).
• Trying Chi Running which takes some of its principles from Tai Chi. You can also purchase the app of the same name.

 Although changing your running style can be difficult, fortunately, some apps make it much easier such as RunCadence.

11. Avoid High Heels When You're Not Running

Women who frequently wear high heels are more likely to experience plantar fasciitis. High heels cause the calf muscle to contract, the Achilles tendon to shorten, and place excessive body weight onto the ball of the foot.  Try to stick to a 1-inch heel or less, and save your stilettos for special occasions only.  

Get Treatment for Heel Pain From Running

Our office offers a comprehensive treatment plan for runners who have plantar fasciitis or Achilles tendonitis. Learn how these conditions are treated here!