A heel spur, known medically as a calcaneal spur, is a common finding for individuals experiencing heel pain, especially those who participate in high-impact activities like running. This bony outgrowth on the underside of the heel bone can be concerning, raising questions about continuing an athletic routine. Understanding the nature of this condition is the first step toward managing it effectively. This guide will provide information on how to evaluate the pain, make immediate adjustments, and pursue professional treatment paths to help you return to running safely.
Understanding the Heel Spur and Associated Pain
A heel spur is a calcium deposit that forms where the plantar fascia connects to the calcaneus, or heel bone. This bony projection develops due to chronic tension and strain on the foot muscles and ligaments. The spur itself can be present for years without causing discomfort, as up to 15% of the population may have a spur that is entirely painless.
The pain that runners feel is not caused by the spur directly pressing into soft tissue. Instead, the pain is almost always a symptom of the underlying condition that created the spur: plantar fasciitis. This condition involves the inflammation and irritation of the plantar fascia, a thick band of tissue running along the bottom of the foot. Chronic tension and micro-tearing cause the sharp, stabbing pain often felt during the first steps in the morning or after periods of rest.
Determining If Running Is Possible
The decision to run with a heel spur and the associated plantar fasciitis must be based on a clear assessment of your pain level. Continuing to run through sharp pain will only worsen the underlying inflammation and delay recovery. The goal is to avoid any activity that increases the inflammation of the plantar fascia.
If the pain is a dull, minor ache that does not worsen during the activity itself or immediately afterward, a gradual, limited return to running may be tolerable. Use a subjective 0–10 pain scale: a pain level of 3 or less during the activity might be acceptable, provided the pain does not increase later in the day or the following morning. Any pain described as sharp, stabbing, or causing a noticeable change in your gait must signal that you stop running immediately.
Runners who attempt to “push through” moderate to severe heel pain risk increasing the micro-tears in the plantar fascia. When returning to activity, start with significantly reduced mileage and incorporate rest days, perhaps running every other day. If the pain level increases or remains above a minor ache, temporarily substitute running with non-weight-bearing cross-training activities like swimming or cycling.
Immediate Adjustments for Active Management
If your pain level permits limited running, several immediate adjustments can help mitigate the stress on the inflamed plantar fascia. Footwear is a primary factor; ensure your running shoes offer sufficient cushioning and stability, replacing any pair that has excessive mileage or worn-out support. Varying your running shoes can also help distribute the impact load differently across the foot.
Incorporating supportive devices can provide immediate relief by reducing tension on the heel attachment site. Over-the-counter arch supports or heel cups made from viscoelastic materials help absorb impact and provide gentle lift to the arch. For individuals who experience significant morning pain, wearing a night splint is beneficial by keeping the foot in a slightly dorsiflexed position, which prevents the plantar fascia from shortening overnight.
Targeted stretching and icing are foundational self-care strategies for managing the inflammation. Regular stretching of the calf muscles and the plantar fascia is recommended to improve flexibility and reduce the pulling tension on the heel bone. Applying ice to the heel for 15 to 20 minutes after activity helps reduce local swelling and pain, often done by rolling the foot over a frozen water bottle.
Professional Treatment Paths and Recovery
When self-management fails to provide relief, or if the pain is severe enough to interfere with daily walking, seeking professional medical evaluation is the necessary next step. A podiatrist or physical therapist can confirm the diagnosis, often using an X-ray to visualize the heel spur, and create a comprehensive treatment plan. Non-surgical treatments are highly effective, providing relief for over 90% of individuals with heel spurs.
Physical therapy is a cornerstone of professional treatment, focusing on specific exercises to stretch the Achilles tendon and strengthen the intrinsic muscles of the foot and lower leg. For persistent pain, a physician may recommend a corticosteroid injection, which delivers a powerful anti-inflammatory medication directly to the site of inflammation. However, these injections are typically limited due to the small risk of fat pad atrophy or plantar fascia rupture with overuse.
Surgery is considered a last resort, usually reserved for cases where severe, chronic pain persists for six to twelve months despite rigorous non-surgical treatment. Surgical options may involve releasing a portion of the plantar fascia to reduce tension or, less commonly, removing the heel spur itself. Recovery from surgical intervention requires a period of non-weight-bearing rest followed by rehabilitation.