Calcaneal Bursitus
I've been dealing with pain in my right heal, kindof in the outer corner, after running for several months now. I am able to run through it and after warming up it doesn't really hurt. The next morning I'm walking on my toes. I've thought it was PF and have worn a boot at night and all that and it hasn't helped. I do run in orthotics, made by a running PT. I saw my doctor yesterday and he diagnosed it as Calcaneal Bursitus. He recommended heel pads to lessen the impact, and wants to inject it with cortizone if it isn't better in a month. I'm wondering if there is anything I can do to heal it and avoid being injected. I'm trying to land more forefoot, rethinking the orthotics, stretching...maybe different shoes....
Any tips and advice?
Thanks! Kurt
Comments
Nothing formal. I thought it was PF so I wore a boot at night for a while and stretched, sometimes iced after a run. I'm trying to lessen heel impact by landing further forward. I wear orthotics on my long runs outside-not on the treadmill-and have orthos in my work shoes. I tape that foot from the little toe side front of arch, around the ankle to the big toe side with athletic tape, then across the arch with KT tape, and another wrap of athletic tape over the first one. Seems to help... That is about it. Finally decided I needed to do something, so I saw my doc, a D.O. yesterday and here I am... asking, wondering what I can do.
thanks!
Dear Kurt,
Your instincts are correct regarding adapting your running form towards a mid foot strike vs. heel strike. The mid foot strike will be the long term cure. a slight forward lean helps with this as does a racing flat or light trainer shoe. shoes with built up heels are just asking for you to heel strike. also shorten your stride, which will help you land midfoot.
For the acute treatment, non steroidal anti-inflammatories will help with the inflammation and the ice, of course, is doing the same thing. rest the heel until you can tolerate running.
As for why one heel and not the other? you are landing harder on the inflammed heel harder than the other perhaps. this could be caused by a leg length discrepancy or muscle tightness on one side or running the same direction on the same uneven pavement all the time.. in either case, it pretty much results in you landing on one heel harder than the other. focus in on this and see if it can be corrected, but the midfoot striking should prevent it from ever happening.
no need to sleep with a boot in this case.
finally, i don't know your body composition, but the lighter you are, the less stress when running at the contact points.
hope this helps and wishing you a speedy recovery.
Gh
Avoid any injections, particularly steroids. Steroids tend to cause fat atrophy, which particularly in this area, is KEY. And once you lose that fat pad, you can eat all the foie gras in the world, and you can't bring it back.....
Good Luck!
I'm having a similar problem... I can run, then an hour (or day) after, my heels kill me. It wears off after a few days, though... at least typically. My twist is that I am a mid foot runner - I've been working on that all season, so I know I don't heel strike. Any thoughts? This morning, just for fun, I stood on my tip toes and dropped down to my heels slowly and kinda felt a pulling sensation.
Becky:
consider the following:
-is the pain near the back of the heel edge or smack in the center of the plantar surface? i suspect the former.
-since you are focusing on midfoot strike, then the heel pain is not likely due to impact at the heel. more likely a result of strain on the tendons in that area. the tendon attachment areas that are under most strain, will be the ones generating the pain. so, this is not calcaneal bursitis.
-the transition from heel strike running to mid foot running requires a more flexible set of muscles and tendons in the lower limb, especially. so, it's normal for you to be going through this phase. once you warm up the pain goes away, right? if so, then this is probably what's going on. tendons take longer to adapt to the new stress than muscles. however, they WILL adapt and the pain will go away eventually.
-i suggest:
-keep focusing on midfoot strike, but make sure that it is truly mid foot and not forefoot. the latter requires even more flexibility and puts you more at risk for injury. forefoot running requires more coaching and technique. keeping the stride short and with high rpms hels to assure a midfoot strike.
-massage the area that has pain before and after your runs. warm up easy until the pain goes away or almost goes away, then stretch (downward facing dog yoga stretch is a good one). now you can do your normal run. naturally, this prolongs your run training time, but it is necessary until your body adapts to the new stress. in fact, the warm up should be the longest part of your workout.
-on the bike, mid foot runners, tend to benefit from the cleats being more towards the forefoot than is recommended in the textbooks for pure cyclists. this will also help you develop flexibility in the lower limb without the impact stress of running.
I went through a similar period for about 6weeks during a phase where i was running with mid distance track runners (i.e. a ton of really fast forefoot running).
this is just one perspective and if it applies to your case, then it should play out fine.
GH-MD
As A massage therapist for endurance athletes over the past 14 years, I would recommend you look past the heel for a moment. I have had a few clients over the years come in with that exact pain and they have spent tons of money trying to "cure" a heel spur or bursitis. In the end, with the help of some good Pt's and sports Doc's, we came to the conclusion of Achilles Tendonitis. The fact that you can "run through the pain" is what tipped me off. Bursitis usually gets worse the more you aggravate the joint, and a heal spur generally does not make you walk on your toes the next day. Have someone look at your gastrocks, hamstrings, glutes and likely opposite side low back. These areas will most likely be very tight, and need to be dealt with along with some Rest, Ice, Compression, Elevation. Ice is your friend no matter what the final "name for what's got you down", So would encourage spending 20-30 minutes with an ice pack after each workout...to avoid walking on your toes. This is just my opinion, and I am new here, so if this is out of place, I hope I did not step on any toes!
Ebe
@becky- time to get to work. worry less about how your foot lands and more about if you're actually pushing off your big toe. as the calf and back of your lower leg stiffen up you stop doing that and then your calf gets overworked. normal calf function is about landing and pushing off. think about the full stride not just the front half. stretch and dig, stretch and dig. hard to get rid of a cranky calf during the OS.
thanks Ebe and Leigh. I saw my chiro today (who does a lot of ART) and mentioned it to him and he put a thumb behind my knee (can't remember the name and I'm sure I would't be able to spell it) and I just about jumped off the table. So the two tendons )?) that cross behind the knee are inflamed and he mentioned that could be causing probs with my gastrocs. he suggested spending quality time stretching my calves, including the downward dog. He also noticed my mid to lower back tight... so, Ebe, sounds like you nailed it.
I didn't run yesterday and I did lots of stretching, including calves and feet after Sat run - yesterday wasn't perfect but better for sure and today is no problem at all... so I'll continue following the course!