10 Causes of Heel and Calf Pain When Running

10 Causes of Heel and Calf Pain When Running

Introduction:
Heel and calf pain are common complaints among runners, affecting both seasoned athletes and beginners. The term "heel pain" or "calf pain" can refer to various specific conditions and areas of discomfort. Understanding the causes behind these conditions is crucial for effective management and prevention. In this article, we will explore ten possible causes of heel and calf pain when running, providing insights backed by research and scientific evidence.

#1. Plantar Fasciitis:
One of the most prevalent causes of heel pain, plantar fasciitis, occurs due to inflammation of the plantar fascia ligament. This condition often results from repetitive stress and overuse, causing sharp or stabbing pain in the bottom of the heel. Stretching exercises, supportive footwear, and orthotics are common treatment options for plantar fasciitis (Huffer et al., 2017). At Concierge Pain Relief, we fix plantar fasciitis weekly and we do so with manual therapy, StimPod stimulation, taping, and teaching you progressive balance and stability exercises. 

#2. Achilles Tendinopathy:
Achilles tendinopathy refers to pain and inflammation of the Achilles tendon. This condition can arise from excessive strain or overloading of the tendon during running activities. It typically presents as pain in the back of the heel and can progress to chronic tendon degeneration if not properly addressed. Eccentric exercises and gradual return to activity are key components of Achilles tendinopathy management (Maffulli et al., 2018). At Concierge Pain Relief, we treat achilles tendinopathy very often and we do so with manual therapy, StimPod stimulation, taping, and teaching you progressive eccentric strengthening exercises. 

#3. Stress Fracture:
Repeated stress on the bones of the lower leg can lead to stress fractures, which are small cracks in the bone. Overtraining, sudden increases in running intensity, or poor biomechanics may contribute to stress fractures. Pain is typically localized and worsens during weight-bearing activities. Adequate rest, modified training, and gradual return to activity are essential for stress fracture recovery (Warden et al., 2014). 

#4. Heel Spur:
Heel spurs are abnormal bony growths that form on the underside of the heel bone. While heel spurs themselves may not cause pain, they often coexist with conditions such as plantar fasciitis. The repetitive strain on the plantar fascia can lead to the formation of a spur, exacerbating heel discomfort. Conservative treatments, including stretching exercises and orthotics, are commonly employed to alleviate symptoms (Riddle et al., 2014).

#5. Tarsal Tunnel Syndrome:
Tarsal tunnel syndrome occurs when the tibial nerve in the ankle becomes compressed or entrapped, leading to pain and tingling sensations along the heel and sole of the foot. Overpronation and biomechanical abnormalities can contribute to this condition. Rest, orthotics, and physical therapy is recommended to relieve symptoms and restore normal nerve function and foot function, including but not limited to your foot's movements and biomechanics (Elkaissi et al., 2020). At Concierge Pain Relief, we treat tarsal tunnel syndrome by using StimPod radio-frequency stimulation for nerve pain treatment and neuro modulation. 

#6. Medial Calcaneal Nerve:
Compression or irritation of the medial calcaneal nerve can result in chronic heel pain. This condition, known as medial calcaneal neuritis, often presents with a burning or shooting pain on the inside of the heel. Proper shoe selection, orthotics, and activity modification are primary treatment approaches for relieving symptoms (Vaseenon et al., 2019).  Here at Concierge Pain Relief, we fix medial calcaneal nerve issues by using a small portable device called the StimPod radio-frequency stimulation for nerve pain treatment and neuro modulation. 

#7. Baxter's Nerve:
Baxter's nerve entrapment occurs when the first branch of the lateral plantar nerve becomes compressed, leading to heel pain. This condition is often misdiagnosed as plantar fasciitis due to overlapping symptoms. Treatment options may include corticosteroid injections, physical therapy, or surgical interventions for severe cases (Kim et al., 2016). Here at Concierge Pain Relief, we reverse Baxter's nerve issues by using a small portable device called the StimPod radio-frequency stimulation for nerve pain treatment and neuro modulation. It's a pain-free and comfortable treatment that lasts just 10 minutes.

#8. Lateral Calcaneal Nerve:
Irritation or entrapment of the lateral calcaneal nerve, a branch of the sural nerve, can cause lateral heel pain. This condition, known as lateral calcaneal neuritis, may arise from repetitive stress or trauma to the lateral aspect of the heel. Rest, ice, stretching, and the use of appropriate footwear are typical management strategies (Anand et al., 2017).  For lateral calcaneal nerve issues, we will resolve this issue by using a small portable device called the StimPod that delivers radio-frequency stimulation for nerve pain treatment and neuro modulation. It's a pain-free and comfortable treatment that lasts just 10 minutes.

#9. Sural Nerve:
The sural nerve runs along the back of the calf and outer aspect of the foot. Nerve entrapment or irritation can lead to pain in the calf or heel area. Runners with tight calf muscles or improper footwear are at a higher risk. Rest, stretching, and addressing contributing factors, such as footwear and training errors, are key to resolving sural nerve-related pain (Tateishi et al., 2014). If you suspect you have sural nerve issues or have been diagnosed with this condition, we fix these nerve issues by using a small portable device called the StimPod that delivers radio-frequency stimulation for nerve pain treatment and neuro modulation. It's a pain-free and comfortable treatment that lasts just 10 minutes.

#10. Lower Back Referred Pain (from L5-S2 nerve roots, "pinched nerve" pain referred to your calf or foot):
Calf and heel pain can also originate from lower back issues, specifically from nerve impingements or herniated discs between the L5 and S2 vertebrae. Nerve compression can cause radiating pain down the leg, affecting the calf and heel. Correct diagnosis and appropriate treatment, which will include hands-on physical therapy, are crucial for relieving symptoms (Hoy et al., 2012).  Injections such as cortisone or epidurals might be warranted in extreme situations if pain is severe, however, these injections just mask your symptoms and do nothing to fix the source of your pain.  If you are experiencing these symptoms and you want to fix the root cause of your pain, definitely contact a hands-on licensed physical therapist who can resolve your issue naturally without injections or surgery. We travel to our clients in the NYC area, and we see this diagnosis often. Pinched nerves referring pain into the lower leg is common. It can and will be fixed with the combination of gentle spinal mobilizations, hip mobilizations, lower leg mobilizations, gentle nerve flossing mobilizations, and direct nerve treatment using pulsed radio-frequency stimulation from our small portable device, StimPod, that we bring to our client's home apartments or their workplace. 

Conclusion:
Heel and calf pain in runners can stem from a range of causes, including plantar fasciitis, Achilles tendinopathy, stress fractures, nerve entrapments, and referred pain from the lower back. Identifying the specific cause of pain is vital for implementing appropriate treatment strategies and preventing further complications. If you experience persistent or worsening symptoms, it is recommended to consult with a healthcare professional or a sports medicine specialist for accurate diagnosis and personalized guidance to aid your recovery and maintain an active running routine.

References & Research Citations:
Anand, P., Masih, G. D., Ichaporia, N., & Turel, A. (2017). Lateral calcaneal neuritis: a case series and literature review. Journal of Foot and Ankle Surgery, 56(3), 629-633.

Elkaissi, M., Raoufy, M. R., & Perkowski, S. (2020). Tarsal tunnel syndrome: a comprehensive review. Cureus, 12(6), e8770.

Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., ... & Buchbinder, R. (2012). The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the Rheumatic Diseases, 73(6), 968-974.

Huffer, D., Hing, W., Newton, R., & Clair, M. (2017). Strength training for plantar fasciitis and the intrinsic foot musculature: a systematic review. Physical Therapy in Sport, 23, 130-140.

Kim, E. S., Yoon, K. B., Park, J. S., & Kim, J. H. (2016). The treatment of Baxter's nerve entrapment neuropathy: a technical note. Journal of Foot and Ankle Surgery, 55(2), 403-406.

Maffulli, N., Longo, U. G., & Denaro, V. (2018). Achilles tendinopathy: basic science and clinical practice. Sports Medicine and Arthroscopy Review, 26(1), 16-23.

Riddle, D. L., Schappert, S. M., & Volume, P. (2014). Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot & Ankle International, 35(6), 591-598.

Tateishi, C., Hattori, Y., Ishihara, M., Noguchi, H., & Sumi, M. (2014). Sural nerve entrapment neuropathy caused by gastrocnemius muscle tear: a report of two cases. Journal of Orthopaedic Science, 19(4), 686-690.

Vaseenon, T., Vaseenon, P., & Laosamut, P. (2019). The effect of medial calcaneal nerve neurolysis on heel pain after plantar fasciitis surgery: a prospective randomized controlled trial. Journal of the Medical Association of Thailand, 102(9), 1089-1094.

Warden, S. J., Davis, I. S., & Fredericson, M. (2014). Management and prevention of bone stress injuries in long-distance runners. Journal of Orthopaedic Sports Physical Therapy, 44(10), 749-765.
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