Heel Pain in Runners – Introduction, Causes, Signs, Symptoms, Diagnosis, Treatment and Outcomes


Our feet can bear a lot of load but loads over the limits can cause pain in your heals as according to an estimate 1 mile of walk puts a pressure of around 60 tons on each foot. Heel pain is one of the main problems reported in runners because they are used to run regularly for longer distances. It can be due to a number of conditions like plantar fasciitis, stone bruise and heal spurs but the most common cause of heal pain among runners is Plantar Fasciitis that is why we are going to discuss it in more detail.

Plantar fascia is a thick band of connective tissue that connect the heal bone (calcaneus) with the toes while making the arch of foot. In plantar fasciitis, this fascia of foot is inflamed due to repetitive irritation because of too much jumping or running. Pain is present mostly under the heel which radiates to the sole of foot which is aggravated with movement.


Following factors can lead to plantar fasciitis in runners and other athletes.

1. Studies have shown that restricted dorsiflexion (flexion of foot in upward direction) of foot is associated with highest risk of plantar fasciitis which means that tight Achilles tendon can be a major cause of heel pain in runners.

2. Wearing hard footwear which do not support foot arch puts direct pressure on plantar fascia, thus causing the heel pain in runners.

3. As feet bear all the body weight while standing and running, sudden increase in body weight or being obese can increase the chances of heel pain in runners.

4. Long distant running, running on hard or uneven surfaces or running uphill can be a leading cause of heel pain.

5. Biomechanical causes like high arch of foot or flat feet can also lead to plantar fasciitis.

Signs and Symptoms:

If you have heel pain due to plantar fasciitis you will feel dull or a sharp pain beneath your heels which is sometimes accompanied with burning sensation in the heel. In this condition, pain may get worse during different times of the day or during different activities when you try to walk:

  • After waking up in the morning
  • After sitting for long time
  • After intense activities

You pain may also be aggravated while climbing stairs.


You need to visit your physical therapist to perform a physical examination because it is a soft tissue injury pain so it is not diagnosed by any imaging test but with your medical history and examination. Your physical therapist will:

  • Ask about your history if you wear hard footwear, run for longer distances and your body weight.
  • Check for biomechanical aspects i.e. if you have high arch feet or you are flat foot.
  • See if inflammation is present.
  • Check your ankle range of motion if it is restricted or not.
  • Press against your heel to feel tender points in your heels.
  • Check if your foot is pronated (bent inward slightly) while standing.

If physical therapist will appreciate more than one symptom of plantar fasciitis, he will diagnose it immediately otherwise he may refer you some other confirmatory tests to diagnose it properly.


plantar fasciitis can be cured mostly by conservational methods such as physical therapy which is described below in detail and you can also treat it yourself after reading it carefully, surgery is rarely required.

  • Icing is an effective method to relieve the pain of plantar fasciitis as icing for 15-20 minutes and 2-3 times a day will reduce the inflammation in your heel and it will also decrease the intensity of pain.
  • Rest is the main point in the treatment of plantar fasciitis because it is an overuse injury of foot. Almost 2-3 weeks rest from running is required; once the main cause is eliminated your recovery will be optimal.
  • Stretches of different kind i.e. stretches for heel and plantar fascia are mainly required to restore flexibility in the muscles and fascia; once your muscles and fascia are flexible enough, the chances of recurrence of this injury are minimized.
  • Taping is often done to treat plantar fasciitis, in which stress from your plantar fascia and related structures of foot is removed by supporting your foot arches through taping. It is usually done by a physical therapist.
  • Footwear which is well padded and easy to wear and extra paddings like silicon pads are prescribed to patients of plantar fasciitis.
  • Night splints to keep your heels stretched while sleeping are also very useful in treating plantar fasciitis.

Outcome of this pain:

In plantar fasciitis, your inflamed plantar fascia will directly put pressure on its attached bones i.e. calcaneus and toes; and if not treated on time it will continue to put pressure on bones that may result is heel spurs or stress fractures. That is why if you are experiencing this pain on initial stages you can treat it by yourself with the above described methods. If you will not give importance to your heel pain and will continue your running activities, you may have to go through a surgery.