Pain on sides of upper heel? (images)

[gossamerj]

Hello all. I'm hoping I can get some help for some heel pain I've been having.

First, a little "history." I'm COMPLETELY new to running (as a 40 year old, healthy male). I'm 5'9" and weigh about 143 pounds. So, not overweight, but I've never run before in my life. Literally.

I started running this year on a progressive program called "the Couch to 5k" (C25k). It's gone fairly well. I've been integrating Chi Running into my program and have been working in racing flats (not barefoot).

It took me a while to get into not heel striking, and I know I was heel striking when the injury began.

Recently I've developed some pain in my upper, SIDES of my heels, just below and behind my main ankle bone.

I've attached images where I marked the painful areas on my foot and a couple illustrations that might show it better:

http://i17.photobucket.com/albums/b61/augusthour/outsidefoot.jpg
http://i17.photobucket.com/albums/b61/augusthour/outsidefootpainIllus.jpg
http://i17.photobucket.com/albums/b61/augusthour/outsideheelpainIllus.jpg
http://i17.photobucket.com/albums/b61/augusthour/photoInsideFoot.jpg

There is very moderate swelling in this area. The pain is worse when I push on the area, but massaging it does help. NSAIDs help. Weight bearing is not as much a problem. But when I stretch my soleus muscles (Wall pushoffs) it hurts a lot and I have limited ability to stretch on the left side compared to the right side.

The pain really started last Saturday when I did some short runs. It really hurt on Sunday so I've laid off it and it feels better, but still sore when I apply pressure and stretch it.

So, does this sound like a stress fracture? Ligament or tendon? Achilles? Worse?

Any recommendations as far as time off to heal?

Thanks in advance for any help or suggestions.

[Heidi]

Hi
It could be a number of things, but I think a stress fracture is unlikely as these are usually not easy to pinpoint where the pain is and develop more gradually.
My advice would be to get some proper running shoes rather than racing flats - you may need more support than this - get your feet checked at a local running shop.
Get some sports massage to the calf muscles to help imrpove the flexibility. Calf tightness tends to be the most common cause of foot and ankle pain.
Stretch the calf muscles frequently, once it is comfortable to do so.

[gossamerj]

Hi Heidi.

Thanks for the reply. I've purchased a pair of more substantial running shoes and plan to wear them and MUCH more gradually over time transition into more minimalist shoes. (Over a period of several months, rather than jumping right into flats).

The more I read the more I'm afraid this might be ligament damage. The pain has gotten less, and only presents itself when I "push off" of the ball of my foot while walking. Weight bearing is only moderately discomforting. It's definitely the stretching that hurts.

Yesterday I rode a stationary bike for 30 minutes with no pain, so that'll be my main source of exercise for a few weeks I guess.

One question: are there any exercises I can do that will help minimize atrophy and the compensating I'm having to do to keep weight off that leg?

Thanks
John

[Heidi]

Yes calf raises are the best exercise to strengthen the whole ankle complex.

[elemai]

Hello

I have experience in treating heel pain. You may not understand what I am about to tell you but I will share with yiou what I know from experience.

Firstly, make sure that you are well hydrated before and after your 5K run and everyday after that.

Maybe it is too quick to be doing 5k runs from being a couch supporter so to speak. Your heel pain maybe is a result from doing too much too quickly and in the process you have potentially injured some vital organs that is causing your heel pain. The description of your heel pain relates to your bladder and kidney and I suspect that you are experiencing deficiency of qi and blood causing stagnation.

Make sure that you hydrate immediately after your 5k run but also have some useful nutrition within the first hour after running.

I strongly recommend you take brisk walks on grass until you gradually built up your body strength and energy to cope with a 5k run.
I hope this information will share some light to your situation and helpful to your heel pain. Hydration is imperitively crucial for your recovery.
Let me know how you get on.

Elemai Lagahetau-Humm
Sports Injury Energy Medicine

[Heidi]

Where exactly do you mean by upper heel? Can you be more specific i.e. the bit you stand on, or at the back of the heel or achilles tendon area etc.

[brokenwing22]

from what your posting it sounds like im having the same issue is it on your right or left side