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pain heel
tuscan72
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Hi all, I've been running all my life but I'm experiencing pain a my heel since last January which prevent me to exercise. It is a sharp pain below my heel and it came gradually over a couple of weeks. Obvoiusly I did not stop running as I thought it was going away, I went to the doctor last March and I was told it is plantar fasciatis and he gave me the exercises to stretch my foot. I did all of them every day for 4 months but didn't help a bit.
He said I need to rest and so I did but after 6 months of rest it is still not getting any better 
I also consulted a podiatrist &chiropodist and I was given custom insoles which I'm wearing all day but still the pain is there. I feel the pain all day when I walk (put the full pressure of my body) so I tend to tiptoeing - and when I massage the hell with my fingers or with tennis ball/roll. Pain is on my left foot only but in the morning when I wake up I have no pain at all. I honestly don't know what else to do, it is just so unbelievably frustrating not to be able run, I asked to do and MRI bit GP said it is not necessary... anyone has experience something similar and do I really need to stop any activity untill I recover? e.g. if it is really plantar fasciatis or hell spur, does running cause a possible rupture of the fascia? pls help!
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Di You get to the bottom of this? I have had similar issues over the last 6 months, I have had physio / xray / excersises / insoles etc. Nothing seems to be helping to get rid of it and not being able to run is driving me nuts!
Thanks for any info.
unfortunately no good news, I have the same pain for 16 months, I just do 2/3 km 2/3 times a week as if I run more the following day it is a pain, doctors said I can wait to see whether it heals or try for a cortisone injection...still postponing as I'm scared it gets worst!
Oh dear, doesn't sound good!! I would probably have gone for the injection by now if I were you, just to see if it helps.
Mine came on initially just putting shoes on and off, the pain was on the back of the heel as if I had a sore, but there was nothing there to see! Then I started to get a pain just when running, underneath my heel at the back, but I was OK afterwards. Then about 3 months ago I did a Parkrun and the pain got worse afterwards to the point of hardly being able to put my foot down. It eased slightly after a couple of days but I have had it 24/7 since, every step I take!
My GP says its PF but I am not so sure! I can pin point the centre of the pain to a spot at the very back of my heel about 1/2" from the floor when I am standing. I have no pain in the sole of the foot or even the front of the heel!
It is difficult to rest it as I have a dog (and a job!) so do lots of walking and standing. I have found that occasional short runs don't seem to make it worse (or better) but I am scared to do more than a run every couple of weeks as I can't risk it getting any more painful.
I have missed several local races this year already that I wanted to enter, its really frustrating isn't it?!
Hope you manage to increase your mileage a bit and I would be interested to hear of the outcome if you do ever decide to go for the injection!!
I feel your pain, I also found hard to believe it is PF but I did the MRI and it didn't show anything wrong nor microfractures except of a thickening of the fascia at the attachment with the bone which is a sign of PF... not just running but even walking to get a train to work is a pain, sooo frustrating!!!!
same spot as mine at the back of my heel, no pain under the foot....I have no problem with cycling ans swimming but are not my fav!
Thanks for your help, it's always good to talk even though it doesn't help the injury!
I insisted on an x-ray about 3 weeks ago as I did suffer from a Stress Fracture in my femur about 8 years ago (running again!!) and was diagnosed as borderline osteoporosis at the time, so though it possible I might have another in my heel even though it very unlikely with the low miles I have been running.
The x-ray was clear but then so was the one I had in my femur!! The x-ray came back clear even though I could only walk with the aid of crutches! I put up with it for about three weeks (with the doctors saying I had a soft tissue injury) before paying privately for an MRI which clearly showed a stress fracture. At least I got to keep the scans as evidence!
Not sure this running is any good for us but for some reason I just don't want to stop!
you are right but I miss the happy feeling after 10k/20k!
Ask for a MRI to your GP, maybe it is not PF in your case?
I think I will if I cant shake it off over the next few weeks. They only offer MRI's very reluctantly though!
I know... they are a pain
Hi tuscan/RTSS
Just wondering how you guys are these days? Just found this thread searching for others with similar issues.
I've had a sharp pain in the centre of my heel on the sole, sustained in March 2015 playing football - impact of my kicking foot hitting the ground on 4G surface.
Long and short, I've had an xray and recently an MRI scan after treating plantar fasciitis for a year and seeing no improvement. It felt like a bruised bone at the time so I left it, Sep 2015 went for xray, nothing found. Left it more, Sep 2016 MRI scan, results recently showed nothing at all.
RTSS would you recommend paying for a private MRI? May I ask how much this cost? The consultant didn't even have the MRI scan image when I went in, only a written description of the findings.
The MRI did show there was no thickening of the PF so I'm ruling that out now and now believe it may be something to do with damage to the fat pads, or to the calcaneus.
It'd be good to hear from you both just to see how you're getting on and if you've found out the cause of the pain - I haven't done a spot of exercise in 3 months now and am at my wit's end!
Cheers
I'm getting better!! I even managed to start jogging again, slowly 2-4 miles each run for now but no pain after
I did the runner MOT where they assessed the full posture, try to google it, they gave me many useful advice.
However the real trick was to rest. And when I say rest it is not just 1 day or a week. I did almost 2 months complete rest, no much walking at all (I got a motorbike to commute). After that I tried to give a go and run 1+ mile, no pain at all! You need to pass the acute inflammation phase, in the past I rested 1 or 2 weeks but pain was still there. Now it is gone
Good luck to you!!
Hi tuscan, glad to hear you're all sorted and thanks for the reply. Must feel great getting back into it again. I'm not familiar with a runner MOT - I'll check that out.
In terms of rest, I walk 10 mins from the car into work and 10 mins back Mon-Fri, but other than that I'm not doing anything other than walking around at home, shopping etc - no running or sport - I consider this to be 'rest', I'm hoping 'rest' doesn't literally mean 'not using the foot'.
Been like this since early August (around 3 months) but no improvement.
The specialist who recommended I go for the MRI did mention a steroid injection to reduce the inflammation and allow healing to begin, but I'm not sure if that was linked to the bone marrow edema that she suspected (this turned out not to be present on the MRI). Maybe that's worth following up though.
Thanks again for your input.
Going back on track is like reborn!!
You can request the MRI on DVD it costs around £20, check with the hospital where you did it. Do you have it at both feet? If you are ‘lucky’ enough to have at one only as I had, you need to immobilize the foot with a walking boot and keep it for 2 weeks, unfortunately when the foot moves it stretch the fascia as well so no chance to reduce the inflammation.
I didn’t like to have the injection done after I read the bad side effects but I was considering the shockwave therapy. After a long search with prices over £250/session, I found a clinic in London that do it for £65/per foot. Apparenltly you need 3 session to make it works.
Let me know if you need more detail, drop me a line, not sure you can post links in the forum.
Hi tuscan,
I had a call from the GP today - he'd discussed my MRI with a podiatrist who agreed with him that it seems likely the pain I'm having is from Heel Fat Pad Syndrome.
I read into this a few days ago when the GP suggested it as a possibility and sounded exactly like what I have - the second opinion seems to confirm this.
Luckily I only have it in my right foot - can't imagine having the pain in both. I've been referred to a podiatrist, guessing I might be in for some custom orthotics - but I will definitely mention ultrasound and see what he says, I've heard it gets results with PF so may help me here too.
I have however bought some Tuli's heavy duty heel cups which seem to have made an instant improvement - almost full weight bearing on my heel tonight and no pain, although I do feel 'something' where the pain is, but it doesn't actually hurt.
I'll post an update on here just in case someone else needs some insight in future.
Hope you're still out and getting the miles in.
Cheers.
Hi Supernova,
I need to start slowly after 2 years of pain, so far so good although my lower legs hurt as they are not used any longer to a proper training
Shock wave Therapy, it is not ultrasound, it delivers focused shock waves to the body, and has been used for a treatment of a variety of conditions including Plantar fasciitis. Browse for "Shock wave Therapy" plantar fasciitis and let me know if you need some direction
Hi RR,
I think you're right, I got a foam roller and was doing my calf religiously when I thought I had PF but that, along with all the other PF treatments including the calf stretches, didn't help me.
Do you think tight calves can bring on heel fat pad syndrome? Almost certain that's what I have now and I was under the impression it comes from impact - my issue was triggered immediately by impact.
tuscan, off to podiatrist tonight so will ask about ESWT and see if there's any recommendation. Thanks.
Update - podiatrist took 5 minutes to diagnose plantar calcaneal bursitis, or policeman's heel.
I'm not 100% certain due to past misdiagnosis but the guy really seemed to know his stuff so I'm happy to go with his advice.
He made me some insoles up that are 9mm thick at the heel which helps a great deal, and has me icing a minimum (no maximum) of 4 times per day for 10 minutes at a time, with an hour minimum in between. Due back next week to report on progress.
He did suggest a steroid injection might be needed but wants to give me a chance to treat it this way first for a couple of months, as it's meant to really hurt!
I've also bought some Crocs to wear around the house rather than go barefoot. Feels so much better than limping around, wish I'd done it months ago. Never mind.
Hi Supernova, I hope the new treatment works!
I wear insoles full time, I got the scholl orthaheel sports which I found very comfortable, my podiatrist gave one pair of expensive one (£295!!) but I tried them for 18 months and pain was still there. For me the healing touch was resting 5+ weeks completely, stretching and KT tape applied. I bought a pair of trainers+insoles only to use in the house, flat shoes, crocs, barefoot are a no go for me.
Good luck with the new course!
£295?!?! I got mine for £35 - but they're not customised or anything. Don't think you can get ones this thick on the high street though. Shame you spent that much for no gain.
Did you ever find out the cause of your pain? I may have misinterpreted what you've said previously, but it sounds like it might have been retrocalcaneal bursitis if the pain was on the back of your heel rather than on the sole like my plantar calcaneal bursitis?
yes, shocking! they were customized but I did not pay for the podiatrist and follow up visits tho...
MRI showed the band of tissue in the foot thickens in the heel region, I was told it is a combination of posture+high arches but who knows. Did you speak to your podiatrist whether Shock wave therapy is effective for bursitis?
hi tuscan,
I didn't ask him last time as he was making other recommendations and I was happy to listen to his advice.
The pain does seem to have decreased a little after the intensive icing but it's not gone - but after 18 months I'm not expecting it to heal overnight.
I'm due back tomorrow to discuss progress and will definitely get his view on shock wave therapy.
Cheers
since you have it at one foot only, have you considered the cast walking boot? Do you have pain when you press the area or even when you walk?
Good luck for tomorrow!
i havent considered it actually - i know you mentioned it helped you though. i don't like the idea of wearing one but if it gets results i may be open to it. what kind of boot did you have?
i'll check it out, thanks.
Podiatrist admitted he knew very little about ultrasound/shock wave therapy, so might have to look elsewhere for that. The pain has decreased a little over just 2 weeks so I'm continuing as I am with the icing for now.
The symptoms sound like plantar medial nerve entrapment.
Not all heel pain is PF. About 25% is nerve entrapment or like yours potentially a bursitis.
It normally does not have the classical morning pain symptoms. And the pain is very sharp and intense.
It may need an ultrasound to diagnose correctly
in the mean time, dealing with the mechanics, like stretching, insoles helps, but the insoles have to have a cushioned aspect to the heel. Maybe 5-8mm silicone
resting it , is vital , as continuing the activity only aggravates.
I did see your post, and took your advice - got myself an ultrasound scan, on 27 feb then an appt with a biomechanist at the hospital just so happened to be the day after.
The ultrasound showed slight thickening of the plantar fascia (something like 3mm) and I was told my pain IS from PF, NOT bursitis as the chiropodist said. I was icing but as I mentioned I was feeling less and less benefit, which matched with this new opinion.
So the day after, the biomechanist had a look. Checked me with ultrasound, asked a few questions and tested the range of motion in my ankle joint. Told him I have a history of recurrent but mild sprains, but they havent happened for a while now.
He thinks it could be something called a fibrous coalition, potentially of the sub-talar joint, and that the pain I feel is referred pain from this.
Repeated sprains are symptomatic of a fibrous coalition, as it reduces the range of motion in the joint, leading to rolling of the ankle.
I have an appt on 10 april for a CT scan, after having had another xray on 1 march. Hopefully the CT will show more than the MRI that I had in september, and hopefully(!) a fibrous coalition.
So I might be getting a firm diagnosis after 2 years, might not be. But the biomechanist said a coalition can be treated with surgery, 3 weeks on crutches or a moonboot (I forget which he recommended most) and then that's it.
So if anyone's reading this thread with unexplained foot pain, don't just wait it out - get it looked at ASAP! It's taken me 6 months of waiting for mine to heal, 12 months of treating the wrong issue, and another 6 months of trying to get a diagnosis!
Nobody looks at these threads until they're injured, do they?
I get a sharp very localised pain at the back of the right heal. Nowhere else. The sensation is like I've just stood on a (hot) drawing pin.
From looking at used running shoes, I do seem to wear the right foot slightly more than the left.
At the moment, I'm resting it as much as I can. I have to walk about for my job, etc. I just don't train. Good job a got a rowing machine the other week.
Does this sound like anything previous posters have suffered?
I struggled with a nagging heel injury that kept me off the road for three years from 2014 until earlier this month. I tried various interventions, all of which have been described above, and eventually saw a podiatrist who suspected we were dealing with a peroneal nerve impingement. We worked on that and that dealt with most of but not all of my problem; what did was when I started doing stretches on my soleus and hamstrings (see p.55 of March 2017 RW magazine). As a sedentary, commuting office worker, it's no surprise my hamstrings are a little tight. Performing daily stretches relieved whatever it was that was pulling on the back of my heel.
Doesn't mean this will work for everyone but holistic approach to stretching/massage - ie just because you have pain in your foot doesn't mean it's a problem contained to your foot - well worth exploring.