This week's question -
I have seen a lot of athletes with heel pain or wearing heel cups recently. Why is that and how can we prevent it?
My answer -
This weeks answer is going to be geared towards athletes - specifically those who do their sport barefoot. Next week we will discuss adults/other athletes with heel pain.
Heel pain in athletes can have a variety of names -severs disease, plantar fasciitis, achilles tendonitis, etc, but they pretty much all come down to the same issue. The bones in the shin and the foot are getting longer at a faster rate than the muscles in that area are. This is very common in athletes who train 4+ days per week as their muscles never get a chance to fully repair and are always somewhat contracted, the bones growing actually causes them to pull more.
Im a very visual person, so I want you to imagine you and someone else are standing facing each other and each holding one end of a bungee cord. Now imagine if you slowly back away from one another, that bungee cord is going to eventually become taught and be uncomfortable in your hand because it is pulling. This is essentially what happens in heel pain. The muscles of the calf or foot becoming taught pulls on the tendon and eventually the bone and causes discomfort.
So how do we help this?
Short term - a 3 part combination of manual stretching/joint mobilization, active stretching and low load long duration stretching.
I have found this combination helps to truly lengthen the tissue. For examples of what I mean by these please respond to this email!!
Long term - Eccentrics, isometric movements at end range and posterior chain strengthening. What do I mean by this? Think that heel raises (standing up and lifting your heels) contracts your calf muscle. We can all agree on that. Now imagine slowly lowering from that position, so the calf muscle lengthens while still contracting - that is eccentrics. Now imagine flexing your foot all the way and then contracting your calf muscle - that is end range isometrics. Posterior chain strengthening refers to making sure all of the muscles that work together with the calf muscle are as strong as they can be to take stress of the calf.
If you have an athlete dealing with heel pain and want to discuss more specifics on this email us at firstname.lastname@example.org