Heel hurts

Question
Hi, I am a runner.  I run 5 to 6 days a week, 30 to 35 miles a week.  I've been running for about 7yrs. now.  I have never had any serious injuries major problems.  But now I have a nagging irritation.  For the past 8 weeks my left heel has been hurting.  Sometimes, it feels like the tendons that attach to it hurt also.  At first I thought I just bruised it, but it hurts chronically.  It hurts the most in the AM till it gets wormed up. It hurts a little when I run, but not to bad most days.  (I run toe to heel.  One day I ran heel to toe some and the next day my heel hurt so bad I could hardly walk until it wormed up.) It hurts the most the day after a 10 mi. run.  I have a normal foot with normal arches.  I keep my running shoes new and in good condition.  I like New Balance trail runners. I run on dirt, hard packed gravel roads, trail and once or twice a week I run on pavement for 4 or 5 mi.

Can you tell me what you think might be wrong with my heel and what I need to do to help it?  Please don't say stop running, I love to run and can't stop!  Also, I went on vacation last month for 2 weeks. Just hiked, didn't run. It still hurt some then and slightly more after I got back and started running again.

Thank you for your time.
Merrily

Answer
This Chicago & Elmhurst Podiatrist says.......

Dear Merrily,

Your heel pain is probably due to an irritated  Achilles tendon insert in the calcaneus (heel bone).
You are also over training- Try cutting back 2 days, until you improve.
If cutting back does not help-then stop for about 10 days and slowly ease back into running.
Achilles tendon problems may become chronic if not treated appropriately. Also moderate pain in the Achilles tendon may indicate tearing of the tendon fibers. That also needs treatment to prevent additional problems
Try PRICE
Protect-perhaps an ace wrap around the ankle and heel and try to limit the movements that aggravate it. Maybe some arch supports in your shoes with a bit of a heel lift.
Rest-Speaks for itself-perhaps the weekend when you are off-rest it.
Ice- As much as you can tolerate. Pros put the injured area into an ice bath for 15 minutes! Try ice packs on the back of the heel instead for about a week.  
Compress-Ace wrap or ankle sleeve
Elevate-Will help if your ankle throbs at the end of the day.
Go to our website store at AnkleNFoot.com for examples of wraps, sleeves or braces for your ankle.
Take max doses of anti-inflammatories (try Alleve) for about 5 days-as long as you don't have any stomach problems.
Stretch your calf slowly and gently, twice a day and BEFORE you get out of bed.
Maybe try a night splint-see examples at our website store at AnkleNFoot.com
If these suggestions don't help  then seek the aid of Podiatrists who are Board Certified in Orthopedics. Sometimes these injuries respond with orthotics(prescription custom made) and physical therapy or other modalities.

Hope This Helps
Good Luck!

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661
AnkleNFoot.com
Runnersdoc.com
BabyFootDoc.com

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