Heel Pain - Getting the proper shock absorption

We talked last month about foot mechanics and how they relate to heel pain. A good orthotic is designed to provide control as your foot moves. Recent online articles, like the one sited below under related articles, try to say that doctors aren't sure why orthotics work. We're not sure what doctors they're talking about because your Austin Foot and Ankle Specialist have extensive training in implementing the right type of orthotic for their patients.  For the patient with plantar fasciitis, the orthotic can help decrease the strain on this ligament and is used in prevention as well as rehabilitation. This article only highlights one area of control that an orthosis offers.

The control custom inserts provide several point of control. A deep heel cup can also help w/ another type of heel pain.  Some heel pain is due to the forces paced on the fat pad beneath your heel. With years of pressure on your heel, this pad can become displaced from proper position.   A good heel cup helps to keep the plantar fat pad under your heel bone in the right place for shock absorption. If you are a heel strike runner, you are putting 4 to 5 times your body weight on you heel every time you strike the ground.  This can be a contributing factor in addition to a number of reasons, including age and foot structure, that cause your fat pad to lack the amount of shock absorption you need.

Many running shoes have quite a bit of cushioning is the heel, but may do so at the expense of flexibility in the sole. The addition of heel pads can be an inexpensive and easy way to add cushion to your favorite running shoe. A cushioning pad placed underneath your orthotic or insole can do wonders to provide the additional absorption you require.   Through our online store, you can purchase Dr. Jill’s Gel Heel pads.  These pads can dissipate the shock of your heel strike, making up for any deficiency in your plantar heel pad.  With proper cushioning you can keep your run free of heel pain!

Related articles

· Some answers about orthotics (eurekalert.org)

• Why do orthotics work? (humankinetics.wordpress.com)

Why do my heels hurt? Answers from the Heel Pain Center of Central Texas

One of the most common foot issues to afflict individuals is heel pain.  As highlighted in the most recent Austin Foot and Ankle Specialists Newsletter, Dr. Thomajan has devoted a part of his practice to it.  There are many different causes for heel pain.  Last month in this blog we discussed one of the causes seen often in children.  In adults, the reasons are often have multiple causes which we will discuss further.

For adults, the problem is often a product of foot mechanics.  A movement of the foot, known as pronation, is critical to normal walking.  It allows stresses to be distributed through the foot until the toes leave the ground for the next step.  When this motion becomes exaggerated or moves past the point that is necessary, it can lead to problems.  The bottom of the foot becomes spread out during over-pronation and causes the arch of your foot to drop down.  This stresses the muscles and ligament beneath your foot often leading to plantar fasciitis.  More information on this can be found in the free book ‘Heel Pain’. Early treatment of this problem involves stretching, icing, and anti-inflammatory medication to provide relief.  This may help your heels feel better but does not correct the mechanical problem that caused it in the first place.  Without proper treatment, it can come back or worsen to the point of a tear in the tissues.

The Heel Pain Center of Central Texas was created to properly treat the causes of heel pain.  A division of Austin Foot and Ankle Specialists there are a variety of treatments available.  X-rays may be used to verify that the problem is in the tendons and muscles and not the heel bone itself.  Specialized shoe inserts, or custom orthotics, can often a good solution if your foot mechanics are the source of the problem.  There are also other non-invasive treatments that can be implemented to help heal damage caused to the fascia.  In severe cases where other treatment modalities fail, surgical intervention may be an option you discuss with your Austin podiatrist.  If you find yourself with heel pain, be sure to make a call to the Heel Pain Center of Central Texas.

Vivo barefoot® – Another option for the barefoot runner

We hope you have taken the time to educate yourself about minimalist or barefoot running before you have tried it.  Barefoot running isn’t for everyone.  We have discussed it before in this heel pain blog.  There are many proponents touting the benefits of it, but there are just as many medical professionals pushing for you to remain cautious.  The biggest concern is injury and infection that can come from getting something stuck in your skin, a big risk when running without any protection.   This concern is decreased with the use of so called ‘minimalist shoes’.   These ‘shoes’ offer a layer of protection for your skin while lacking the support of traditional running shoes.

There are many options out there is you are shopping for these minimalist shoes. Today we want to highlight one of those options; the Vivo barefoot®.  These shoes claim to be the first of these minimalist shoes on the market.  They claim to offer protection against punctures but with a specialized sole that allows for proprioceptive feedback.  Proprioception, your body ability to recognize positioning and to adjust muscle strength accordingly, has been a key to physical and rehabilitative therapy for some time.  A key to recovering from ankle sprains and injuries is early therapy to allow for this sensation to help guide you body to heal properly.  The theory is that this same proprioception can help strengthen the muscles in your foot, making you a better runner.

We feel this shoe is best suited for the committed or competitive runner who would like another element added to their training regime.  By wearing these on your off days, or for your occasional short distance, you may help the muscles in your feet to work better.  These muscles have a great influence on the joints and structure of your foot.  We have to recommend that you have your foot assessed by an Austin podiatrist.  Everyone’s foot structure is different and you should make sure that yours will function well with minimal support.  Doing so can keep you from having heel pain and many of the other injuries that are starting to surface in barefoot runners.

Back to School Heel Pain – Severe’s Disease

While most of the blogs on the Austin Runners and Heel Pain site focus on the adult runner, we wanted to throw in a source of heel pain for the younger runner. Fall sports are in full swing with school back in session and we want to make sure your kids are avoiding injury.  It is important to have the proper footwear for activities to prevent injury.  Unfortunately, problems, like Severe’s disease, can result even with the proper footwear and often is a result of overuse.  This blog will cover a little more about what it is and things you can do to help resolve it.

Calcaneal apophysitis or severe’s disease is a condition that typically appears in children between the ages of 8 and 14.  Up until the mid to late teen years, bones are still growing.  Bones are created out of a cartilage scaffold and some of this cartilage remains as a growth plate to allow for lengthening and expansion until children reach their adult size.  The growth plate in the heel bone can become inflamed and painful if too much pressure or tension is placed on it from activities.  The Achilles tendon also inserts onto this growth plate can also aggravate the problem if it is tight.  Foot mechanics can often be a contributory factor but it difficult to discern which children will be affected from those that will not.  While the cause may not be clear, the treatments to alleviate it are.

Heel Pain Center of Central Texas a division of Austin Foot and Ankle Specialists is dedicated to keeping everyone, especially your children, pain free.  One of their monthly newsletters discussed some of the characteristics of this condition. While you should follow up with an Austin podiatrist if this happens, reducing your childs activity and icing the area should help to reduce discomfort.  Additionally, they should avoid going barefoot and wear supportive shoes to alleviate pressure on the area.  Heel pads and arch supports may be useful to cushion the tender heel as well as remove tension from the Achilles.  With early intervention and proper treatment, your child can get back to the activities they love and make this heel pain an unpleasant memory.

Marathon Running – Making sure your feet are ready

Running long distances, such as marathons, asks a lot of your body. If we believe the story from ancient Greece, the individual who ran the extended distance to report victory of the Battle of Marathon died shortly after arrival due to exhaustion. The mondern marathon may only be a tenth the distance of that feat, it is still a challenge for your body, especially your feet. The pressure of a single foot striking the ground with the full force of your body can have damaging effects over 26.2 miles . 


Fractures require immobilization while they heal and are the most limiting of any foot injury. Good nutrition and a balanced diet, including vitamins C & D, are crucial for good bone health. By training properly and slowly increasing the distance you run over weeks and months, you give your body the chance to build the bones up stronger allowing them to stand up against the new challenges. Cramping and tendonitis can also be avoided by building up to long runs and not doing too much, too quickly. If you have given yourself able time adapt to the new distance, the problem may arise from the structure of your foot. This just means your foot needs extra support in the right places. Austin Foot and Ankle Specialists have shoe recommendations for your foot structure or you may find that you benefit greatly from a simple over the counter arch support. Some feet may require customized orthosis to provide this support. 

Calluses and blisters occur when there is too much friction between your foot and the sock and shoe. Poor fitting shoes can result in these problems as well as blackened toenails. All three of these are a result of a repeated trauma to the area of the foot. To avoid them, wear good socks with proper padding and make sure your shoe is a good fit.

Even if you are a regular runner make sure you take every step to prepare your feet for a marathon. While prevention can be the best cure sometimes, don’t hesitate to contact your Austin podiatrist if foot or ankle pain is affecting your marathon training.

Muscle tightness and Equinus – A source of heel pain

As a runner, warming up and stretching are probably common parts of your running routine. The benefits of stretching, including increased blood flow, better joint function, and decreased injury, are numerous. Muscles will tighten with use and age. Without regular exercise and stretching, these tight muscles often lead to pain or injury. An Achilles tendon rupture is often the result big expectations placed on unconditioned ankle tendons. While many regular runners won’t experience this, heel pain can be a prime example of pain that occurs with muscle tightness in your calf muscles.  
 
Equinus is a term used in podiatry to explain tightness in these muscles that affect foot function. Similar to a horses’ hoof being pointed towards the ground, the most severe cases of equinus exhibit toes pointed towards the ground. Most individuals in modern society have decreased motion at the ankle joint or mild equinus. This can be a contributing factor to conditions such as plantar fasciitis. The tendons of the plantar fascia insert onto the same heel bone as does the Achilles tendon. Tights in the calf or Achilles tendon can contribute to tightness in the plantar fascia, one of many sources for heel pain.

Even if you are not a daily runner, you should become a daily stretcher. There are many stretches for runners that are excellent for stretching out the calf muscles. If you are a regular runner and stretcher, your heel pain is most likely from a different source than muscle tightness and should be evaluated by a podiatric physician. The Heel Pain Center of Central Texas website has a lot of good information on this topic. As a division of Austin foot and Ankle Specialists, they are well equipped to diagnose the source of your heel pain. They can also offer you a variety of treatment options including the newest addition of ESWT. Heel pain can start for a variety of reasons and severely limit your activities. If your running routine or daily activities are being limited by heel pain, make an appointment to see Dr. Thomajon. A call to 512-328-8900 can have you well on your way to eliminating or correcting your source of heel pain.

Avoiding Blisters - Keeping your feet in running condition

Blisters may be the most common malady for sports in general. For anyone who runs long distances or marathons, you may have come to accept some skin chaffing, blisters on your feet, or blackened toenails as a price of completing this feat. You shouldn’t! Just like you can avoid chaffing with proper clothing, you can also take steps to avoid blisters. Before we talk about the best way to avoid blisters cramping your run, let’s talk about why blisters form.

When we run, or walk, the forces that propel us forward also create forces where our feet meet the sock, shoe, and road. The back and forth or side to side forces create a friction between your foot and the surfaces it contacts. Your increased body heat, and moisture from sweat can greatly multiply these frictional forces. The talcum powder or Vaseline that you may have been told can help actually does so for only a short time. After about an hour, these products actually increase these forces as well. Your skin is made up of five layers. Over the miles, these frictional forces cause a cleavage, or tear in which the top three layers pull away from the bottom two. This area then quickly fills the clear fluid that is the trademark of blisters.

The blackened toenails we mentioned earlier are often a result of poor fitting shoes. If the fit is loose enough for your toes to slam against the front of your shoe, there is also a good chance there is enough slide to form friction blisters. This isn’t likely the cause for most runners. Instead, you should look at your socks and insoles in order to resolve this potential problem. Because moisture amplifies the friction, consider ditching cotton based socks and look for something that will better wick away moisture and keep your feet dry. The next thing you should look at is your insert. Is it worn in any area? A good insert can decrease frictional forces by 25%! All these things can help prevent blisters from occurring. If blisters do form, despite all these precautions, you shouldn’t pop them as this will increase pain and leave you open to infection. Instead, visit your Austin podiatrist who can show you how to properly treat and protect this area.

Keep those feet running and pain free Austin!