Running question (heel injury)
 

I started doing a run/walk program three weeks ago to get me up to speed for the running part of an olympic-length triathlon later this summer. I think my problem is not so much cardio, but stretching out all of the tendons and ligaments that are otherwise unused in my daily life (I'm up to 6-min running segments now!).

Anyway, the bottom of my heel started hurthing a couple days ago. It's nothing drastic, but I prefer to avoid walking on it when possible now. Has anybody else experienced pain in this area when they began running? My health coverage is pretty lousy, so I'd prefer not to go see a doctor if it's just something silly. I've read a couple things on the web, but they sound more serious than what could have happened in 3 weeks. I'd definitely appreciate any help that may be provided!

it doesn't seem to be all too drastic. the "orthopedic system" (not a medically sound term) hast to get used to the strain caused by running. which is why many people say that you shouldn't drastically increase mileage too fast. 10% every 4 weeks is one of those "golden rules" i hear rather often.

i could observe this myself over the last 8 months or so. whenever i increased the mileage per single run or per week i would feel a sprain somewhere in my legs. usually it would go away by itself after a few days if i cut back on running.
now i am still aware of this fact and to avoid injury i try not to do runs on days in a row. if i do, then i will make sure, that one of the runs is only a short easy run. ("short" being relative of course)

so if you say that you basically just started running regularly 3 weeks ago i would say that that is normal. however, it is extremely important to remain selfaware and to listen to what your body is trying to tell you! so i am basing this recommendation on your diagnosis that "it's nothing drastic"...

another thing i wanted to bring up are shoes. it could be that your not using good running shoes (or shoes that fit your build).

maybe you can give us a little more info about how many days per week you've been running now, how much running you did before that and what kind of distances were talking about...

Pain of any kind should be taken with caution until you gain experience in understanding how bad is bad - and you know your body. With experience you will know when you can continue to work through an injury or when you should back off.

It could be caused by a ton things and no one here or anywhere else (forum wise) can tell you "how" - "what" or "why" it is happening.

If your just starting out check out http://forums.runnersworld.com
There are a ton of great runners that hang there, especially on the marathon forum - so over time it will be a great place to learn in the future. Maybe in time you may want to even become part of our mileage game.

A few thing to ponder -
1. Are you in the right shoes? The correct size? What type of shoe do you really need - are you a "stability", "cushion" or a "motion-control" runner? Are you running with the correct socks?
2. If it were me the first thing I would do is switch my shoes (I rotate between at least 4-different pairs of different types and different mfg's). daily so that I'm not runing in the same pair of shoes 2-days in a row.
3. Change your running surface (my daily run is no less than 9-miles but it is a good combination of hills, trail, blacktop, and concrete) to change things up enough and to place emphasis on various muscle groups.
4. Develop a "hard" - "easy" approach to your training
5. Change your training routine, in that you are not doing the same thing every day.
a. Change the distance of each run
b. Change the purpose of each training session (even when building base miles/time it's important for your body to gain experience within the various training zones)
6. One of the most useful things you can do is keep a runners/training log - recording such things as the distance (or specific loop), your time, the weather, your overall progress and any pains you may have or develop. I know when I'm due for a rest, a cutback day or wheather I'm "race ready" by the data in my daily training log.


Good luck

tri-berkeley: Congrats on being up to 6 minutes. I'm a firm believer of the run/walk approach. Let's see if we can't narrow things down a little bit regarding the pain you're having. When you say that the bottom of your heel hurts is there one specific location that hurts or is it the entire area of the heel? Something that may help is to take a small size gatorade bottle, fill it 2/3 full of water and freeze it. I like using gatorade bottles because the sides are not smooth and the ridges feel good when you roll your foot over them. After running roll your foot over the gatorade bottle for several minutes and see if this helps relieve the pain.

Also, tell us a bit more about your run/walk build up schedule. What date is your olympic distance traithlon?

Two possible causes - planta fasciitis or a bone spur. Both are overuse syndroms. As the other poster said, these happen by doing too much too quickly. Do a search on planta fasciitis and you'll find some detailed items to determine if this is what you have. Usually some backing off in training combined with some easy stretches help. A bone spur may require medical attention.

Well, I just bought new shoes on Saturday from a local store that specializes in a medical approach to these things, so maybe that will help.

My program so far (to avoid over-doing it) is running 3 days/wk and biking 3 days/wk - swimming is my strong sport so I'm holding off until the weather is warmer. For the running part, each run is approximately 30 minutes and so far mostly on concrete and blacktop for convenience.

Week 1: walked 10 minutes at beginning and end and 2 min running segments w/ walking between until I felt rested (1-2 minutes)
Week 2: 8 minutes walking at beginning and end working up to 4 min running segments
Week 3: 5 minutes walking at beginning and end working up to 6 min running segments

You get the picture here - the idea is to get up to running 30 minutes in about a month and a half. I plan to do a couple sprint triathlons starting in June and the olympic length triathlon I'd like to do is August 21. There's another one in November too.

The particular pain that I'm feeling over the last few days is on the outside part of the heel away from the achilles tendon. It feels more like a bruise than anything else, but a bruise I have to walk on each day. I'm going to probably chalk this up to moving too quickly for now and take a couple extra days off (or cycling as the case may be).

Thanks for all of the quick replies!

Bone spurs are often called "heel bruises" because that's how one describes the pain. The rapid and harsh impact from starting running causes a little chip of bone to break off. It gets caught up in the tissue and feels like a bruise. Often these dissolve on their own. If not, your doctor may have to give you a shot to help it along.

Does your plan include any recovery weeks in it or does it constantly build? For example as a recovery week I would expect to see something like this for week 4:

6 minutes walking followed by 3 minute run/walk

Assuming it doesn't contain recovery weeks I would add them myself or change the schedule to only increment by 1 minute per week. This will give you a more gradual build process which won't stress your body as much.


That's good to hear. Pain on the front and towards the arch is most likely plantar fasciitis. At least it was when I had it.

Good luck getting past the pain.

Tri-Berk,

One guess would be "pseudo bone spurs." The pain mimics what would be expected from a serious bone spur. An X-ray might even show a small "spur." However, the pain is very often caused by the tendon that lays over the heel. That tendon is hooked from the arch all the way up the leg.

It is an overuse injury that occurs when muscle is added quickly and the muscle/tendon group is shortened. Apparently stretching the tendon over this part of the heel puts hundreds of pounds of tension on the tendon right at the heel. If you are not stretched, ouch.

This very non-scientific explaination is the one my doc gave me. Massaging and then stretching the calves and hamstrings BEFORE getting out of bed each morning was a tremendous benefit. Coupled with non-steroidal anti-inflamatories, I beat this deal in about three weeks. Once beaten, close monitoring can reveal relapses before they are serious. It sounds stupid, but loosening the leg muscles BEFORE taking the first step out of bed each morning is crucial. One hard misstep to begin the day and pain follows.

With poor Rx coverage, try a little rest and the massagine alone. I am sure it will help. BTW, I hate stretching and only seldom do it. This is an exception. I normally touch my toes a couple of times and go out the door for my routine 4-mile run. 8:30 pace. I'm 54 and weigh 200 if that helps put my advice in perspective. Been doing this stuff for almost forty years now.

Sorry for the longish post.

Tyson

[QUOTE=ZackJones]take a small size gatorade bottle, fill it 2/3 full of water and freeze it. I like using gatorade bottles because the sides are not smooth and the ridges feel good when you roll your foot over them. After running roll your foot over the gatorade bottle for several minutes and see if this helps relieve the pain.QUOTE]

Good therapy tip -
I like using those cold freezer gel-packs which I hold in place with an ACE bandage should I ever have any issues. But the rolling of the bottle as you describe is a good idea.
I also have one of these log rolls (in photo, from RRS) as well as "The Stick" which I tend to use after my long weekend runs. Sometimes "heat" is good too. I also found some very cool heat packs at the Boston Marathon expo last year, called "Genie Heat Pack". By just bending a tap inside it crystalizes and gets hot (good for maybe 30 min) and you just boil them for 15 min. to return them to their orginal state.