Running and Heel Pain: Causes, Treatment and How to Keep Training

Heel pain is one of the most common complaints among runners — and one of the most demoralising. When every step at the start of the day is sharp and stabbing, and the prospect of a run feels genuinely difficult, it's easy to either push through inappropriately or stop completely. Neither tends to produce a good outcome.

At Finest Feet Footcare in Shifnal, we see runners with heel pain regularly. The good news is that most causes are well understood, very treatable, and — with the right approach — compatible with continuing some form of training throughout recovery.

The Most Common Causes of Heel Pain in Runners

Plantar Fasciitis

By far the most common. The plantar fascia runs along the sole and bears an enormous load during running. When the cumulative stress exceeds what the tissue can handle — from a sudden mileage increase, inadequate footwear, tight calves, or a change of surface — it becomes inflamed at its heel attachment.

Classic signs: sharp inner heel pain with first steps of the day, easing after a few minutes, returning after long runs. Pain often worse the day after a hard session rather than during it.

Achilles Tendinopathy

Pain at the back of the heel or along the Achilles tendon — typically from the tendon being overloaded. Often develops after a rapid mileage increase, speed training, hill work or a change to minimalist footwear. Can coexist with plantar fasciitis.

Heel Stress Fracture

Less common but important not to miss. A stress fracture of the heel bone (calcaneus) causes deep, aching heel pain that worsens progressively with activity and doesn't ease with stretching. Pressing the sides of the heel together (the squeeze test) is painful. This needs imaging and medical assessment — continued running on a stress fracture risks a complete fracture.

Fat Pad Bruising or Atrophy

The cushioning pad under the heel can be bruised by impact (particularly in minimalist shoes or on hard surfaces) or gradually thinned by age. This causes a generalised heel tenderness rather than the localised point of plantar fasciitis.

Should You Stop Running?

The default advice of complete rest is usually wrong for plantar fasciitis and most Achilles tendinopathy. Rest removes load from the inflamed tissue, which can provide short-term relief — but it also allows the tissue to further decondition and tighten, meaning the pain often returns the moment running resumes.

A better approach: modify training rather than stopping completely.

•       Reduce mileage: Cut back to 50–60% of your usual weekly distance while recovering.

•       Avoid hills and speed work: These create the highest loads on the heel structures. Flat, easy running is better tolerated during recovery.

•       Choose softer surfaces: Grass and trail rather than road and treadmill during a flare-up.

•       Substitute low-impact alternatives: Pool running, cycling and swimming maintain fitness without loading the heel.

•       Warm up properly: The plantar fascia and Achilles are most vulnerable when cold. A thorough warm-up before running and stretching immediately afterwards reduces injury risk.

The Treatment Programme That Works

1. Stretching — Daily, Not Just Before Running

Calf stretches (both straight-leg gastrocnemius and bent-knee soleus), and plantar fascia stretches should be done morning, after sitting and after running — not just as a pre-run warm-up. The plantar fascia stretch before your first steps of the day (while still in bed) is particularly important.

2. Footwear Review

Running shoes over 400–500 miles have significantly reduced cushioning — often invisibly. If you can't remember when you last replaced your trainers, it's time. Ensure your shoes have adequate heel drop (the height difference between heel and toe) and consider a temporary switch to a higher-drop shoe during recovery.

3. Insoles

A heel-cushioning insole with arch support reduces both impact and fascial load. For plantar fasciitis, semi-rigid arch support insoles are more effective than purely cushioned ones.

4. Strengthening

Calf raises — particularly the eccentric (slow lowering) phase — strengthen the calf-Achilles complex and reduce the load transferred to the plantar fascia. Intrinsic foot muscle strengthening (towel curls, short foot exercises) supports the arch.

5. Professional Assessment

If heel pain has been present for more than 4–6 weeks, isn't responding to the above, or is affecting your ability to run at all, a professional assessment identifies what's specifically driving your pain — and ensures you're doing the right things rather than generically treating the wrong condition.

Heel pain limiting your running? Book at Finest Feet Footcare in Shifnal →

Frequently Asked Questions

Can I run a race with plantar fasciitis?

It depends on severity. Many runners with mild to moderate plantar fasciitis complete races without significant short-term harm — the adrenaline often masks pain during the event. The issue is what follows: a long race often causes a significant flare that adds weeks to recovery. If you're committed to racing, at least follow the preparation and recovery protocol carefully.

How long does runner's heel pain typically take to resolve?

With appropriate treatment — stretching, footwear, load management — most cases of plantar fasciitis improve significantly within 6–12 weeks. Full resolution can take up to 12 months. Achilles tendinopathy has a similar timeline, with mid-portion cases responding better than insertional. The key variable is consistent treatment, not passive rest.

Should I change my running gait to avoid heel pain?

Gait changes — such as increasing cadence or shifting to a more midfoot strike — can reduce heel loading and may help some runners. However, gait changes need to be implemented gradually to avoid transferring the problem to a different structure (forefoot, Achilles). Abrupt gait changes have their own injury risks. A professional gait assessment is worthwhile for persistent cases.

Is barefoot running good or bad for heel pain?

This is debated. Barefoot and minimalist running shifts load away from the heel and onto the forefoot and Achilles. For some runners with specific biomechanical patterns, this is beneficial. For others — particularly those with established plantar fasciitis — it significantly increases Achilles and forefoot load. It's not a simple cure, and any transition to minimalist running needs to be extremely gradual.

Book Heel Pain Assessment in Shifnal

Don't let heel pain derail your running any longer than necessary. Our team at Finest Feet Footcare in Shifnal can assess your heel, identify the specific cause and help you put together the most effective recovery plan — keeping you moving as much as possible throughout.

We see patients from Shifnal, Telford, Newport and across Shropshire.

💚 Book your appointment at Finest Feet Footcare in Shifnal → — get back to running, pain-free.

Disclaimer: This article is general information and not a substitute for a clinical assessment. If you have diabetes and are concerned about your feet, please also consult your GP or diabetes care team.

Phone: 01952 872526
Email:finestfeetfootcare@gmail.com

Opening Hours: Mon–Fri 9 am–5 pm, Sat by appointment

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