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Two years of heel pain
fastballrc
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Apologies for the lengthy and fairly dour nature of this post, but this is the product of a running nut being forced into abeyance without any plausible explanation.
While training for Edinburgh Marathon in 2014, I developed pain underneath my right heel that has never gone away, and climaxed agonisingly in June that year. I tried to train through the pain for a few months but that didn't do any good, so I've been on the sidelines, trying desperately to get well enough again to walk pain free, never mind run.
I've seen various practitioners, through which plantar fasciitis and Achilles tendonitis have been ruled out. And I've accessed the following treatments: custom orthotics, one cortisone injection, 6 x dry needling, 3 x shockwave therapy, extensive physio-led massage, introduced a footrest underneath my desk after a work station evaluation, slept in Strassburg sock and Ossur Night Splint, taping, complete rest and icing.
Still no further forward and continuing to experience sharp pain underneath the main heel bone in my right foot, which is most pronounced when getting out of bed in the morning, standing up and walking after a period of sitting down. Wearing shoes offer some comfort compared to barefoot, but pain/discomfort is still present 100% of the time when weight bearing. This is especially the case when my full body weight is placed on the heel, or while I'm cradling my 8 month old son.
I've had two MRIs, the most recent of which was on 4 July. According to orthopaedic surgeon, MRI result showed a healthy-looking foot, with no signs of serious physical damage. No evidence of thickened plantar fascia, muscle oedema, fatty atrophy to point toward a Baxter’s entrapment or bone bruising, with the conclusion that there is no clear cause as to what is causing pain.
I do have a history of a tight sciatic nerve and have been working over the last year with an osteopath to loosen it, and have made progress. However it was recently suggested to me that my sural nerve is also a bit tender and have spent time recently mobilising it.
No change has been noted regarding the constant weight-bearing heel discomfort.
Does anyone else have similar experiences, or any advice?
With thanks
Ross
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Comments
"experience sharp pain underneath the main heel bone in my right foot, which is most pronounced when getting out of bed in the morning,"
I have this atm. It only hurts in the morning when I step on it. This is textbook plantar fasciitis I think. How do they rule it out?
I don't think there is an easy cure. It has got better for me not running but I caught it very early and very cautious these days. Perhaps this is a good thing given your nightmare. I walked on my toes if it hurt in the morning. Tight achilles can contribute.
AFAIK plantar fasciitis is not a thickened fascia so won't show up on a scan. I have had it before, it generally goes away in a several weeks off running. Cross training such as swimming when you have this is a good idea.
Thanks Linsmc. Good luck with the cortisone - didn't work for me but I know it works for others, so fingers crossed for you.
For the last few days, I've been mobilising my sural and peroneal nerves, which has been positive. But watching a yoga video on Saturday made me reconsider my plantar fascia; it might not be thickened, but it might be stiff.
So I've been doing some of these sorts of exercises (sitting on my heels with kness and toes flat on the floor) - and early results are positive. Just got to keep it going.
http://myfiveminuteyoga.com/1144/five-minute-yoga-challenge-greet-your-feet-in-the-foot-work-series/
Also been rolling my hard stick roller under my foot for a few mins in the morning, afternoon and night.
We can beat this.
Hi Ross, just checking in with interest having read your thread to see how you're getting on? I'm going to try the link you posted for my own foot problem at present. I hope it's helping; these foot problems are so frustrating!
Thanks. Did this for a few weeks and after some early and modest improvement, things didn't improve any further.
I decided to see a podiatrist last week who, after an examination where he hit on pain almost immediately, has suggested that a Baxter's nerve entrapment (or Sinus Tarsi Syndrome) may be the problem.
Seeing him again in October, where there may be a cortisone jab involved.
Good luck with your treatment Sarah.
Don't give up, listen to your body and be patient...
describe/link to the stretches please
Ta!
Looking it up (as we do these days) I appear to have text book plantar fasciitis.
I've changed my shoes, and will try an orthotic insole I bought in Boots the other day.
I've been stretching & rolling like a madman. Hopefully this will do it.
Thanks for the post. I am really worried about this one. I do know some people have this heel pain and it takes years to get rid of it.
Ask and ye shall receive, LessFatStillFat...
Some thoughts on my recovery, which is ongoing. The good results I’ve had as of late have come after 3 years of treatment interventions listed in my initial post, and all of which are hard to quantify.
And I can’t emphasise that enough that what works/has worked for me will not necessarily transfer to others, as I suspect my injury is a cocktail of things. My injury has been suggested to me as being Achilles Tendinopathy, with some bursitis thrown in. Also felt a bit plantar fasciitis-y as foot felt very sore first thing getting out of bed in the morning but tended to loosen off as day went on.
After 2.5 years of little progress under a variety of ‘specialists’, I went to see a podiatrist in Edinburgh who was recommended to me in winter last year. Things improved dramatically over 6 months with him, to the point that I am now running mostly pain free.
He suspected we were dealing with a peroneal nerve impingement, so we did a series of things to address this as a potential cause. This included diagnostic cortisone injections in and around the base of my foot and sore heel, and some dry needling up and down the peroneal nerve.
When we hit upon the idea that we might be dealing with a peroneal nerve impingement, this led him to start exploring further up my leg (all of my physio from May 2014 onwards, up until seeing the podiatrist, was focussed on my heel/ankle). He worked hard on the area of my outer right ankle starting just below my kneecap and I started to feel less pain when I got out of bed in the mornings. Things improved so much that in January this year – for the first time since summer 2014 – my foot felt strong enough to do suspension and conditioning fitness classes. I’ve been doing them every week to this day and the right heel, until, May, felt fine, if not quite 100%.
Apropos of nothing, in May, I started doing some injury-proofing exercises that I found in March 2017 issue of Runner’s World (starting on pg 55), that were badged as ’12 minutes of exercises for the whole body to do daily’, with different exercises for every day of the week.
One of the exercises was for a soleus stretch, and doing that seemed to hit upon some real tension in my right leg. The stretch looks like this:
http://www.sportsinjuryclinic.net/rehabilitation-exercises/stretching-exercises/foot-ankle-stretches/soleus-stretch
I held it for 45 seconds on each leg and did it morning, noon and night for a week. I also started reading about stretching areas around the soleus and that led me to place more emphasis on stretching my hamstrings. Hamstring stretches are 10 a penny; millions to choose from on Google. I try to work on the soleus and hamstrings every day and notice if I miss a day.
The pain in my foot is now miniscule in comparison to where it was a year ago and I’m able to run on it - woo bloody hoo. As I mentioned earlier, I suspect the problem in my heel was the culmination of a few things – probably nerve impingement, perhaps ‘overuse’ from intense (90/100 miles p/w) marathon training I was doing in late 2013/early 2014, and tightening in my hamstrings from sitting at a desk all day. I also had a pretty horrible family bereavement in early 2014 which I think had some sort of effect too.
Reflecting on when my pain started in June 2014, in August 2013 I moved house, which meant that a 60 minute walk to work in the morning (repeated in evening) was replaced by a 50 minute train ride. So 8 hours of sitting at a desk all day now compounded by another 2 hours of sitting on a train - and then I get an injury 9 months later, the likes of which I'd never had in 14 years of half marathoning/marathoning - I doubt that is a coincidence.
Anyway, my takeaways are:
See a good sports physio/podiatrist – all of the ones I saw offered helpful contributions, but the experienced podiatrist was the one who really made things happen. And you will get some SPECIFIC advice relevant to your body. We’re all here in this forum because we’re a bit desperate for a solution, aren’t we? And desperate people can make daft decisions.
Try to rest and don’t push through injury – I should have stopped in June 2014 when everything started but kept trying to run all summer to keep a personal goal moving along. Stupid. Listen to your body.
Do the exercises – if you have a diagnosis and get some exercises to do off the back of it, do them. Find a way.
Get off your a**e - sit less, walk more. I am going to pursue getting a standing desk to deal with my sedentary issue.
I don’t see myself as being completely out of the woods yet; there’s still a little discomfort around the heel, which comes and goes for reasons unknown. And a mega relapse may happen when I start banging out miles.
But I am in a place that a year ago, I would have killed to be in.
Good luck in your own journeys.
I do agree, often injuries are the culmination of different, and ostensibly unrelated things that gather pace unseen until something gives.
You're right as well - listen to your body. Pain is there for a reason.
Managed to interrupt training a couple of weeks ago by cracking toe running down stairs. Ached like hell for most of the fortnight. Thought I'd broken it, but thankfully not.