How to Stop Heel Pain When Running

Heel pain when running can be improved, not with orthotics, but by avoiding heel strike and instead, landing on your forefoot.

The Cause of Heel Pain When Running

Heel Striking in Cushioned Running Shoes

Heel pain when running is typically associated with a pronounced heel strike, which is troublesome because heel striking generates a large ground reaction force as well as an impact transient, causing the heel pad to reach it’s physiological maximum.

Under-heel plantar pressures also increases as the speed of heel strike running increases, which again, increases the heel pad’s physiological loading beyond its deformable limit [1].

  • At a certain speed, the heel pad is no longer deformable and ‘bottoms out’ [1]. As a result, the rest of the foot is exposed to insufferable loads, even when a thickly cushioned shoe is worn [2].
  • Even more bad news, under-heel cushioning exacerbates heel pain when running because the complexity of heel/shoe interactions is influenced by the heel pad’s time dependent material behavior [2].

Nerve Compression

Heel pain when running also can be due to a compressed medial plantar nerve. This nerve compression occurs when adjacent soft tissues swell due to high impact exerted on the heel.

For example, at heel strike, generation of transient impacts, reach magnitudes of four times body weights and triggers repetitive tissue deformations and ruptures of fibrous components in the heel pad.

Heel pain when running
Heel strike-transient overloads the heel pad, resulting in local tissues to swell and compresses the medial plantar nerve.

Less Heel Pad Stress with Forefoot Running

Many researchers conceptualize heel pain as an impact-related heel pathological condition whereby relieving stress inside the heel pad is an overriding concern.

Data confirms that forefoot running significantly reduces internal heel pad stresses because the forefoot receives most of the landing pressure [3]. Landing this way would also reduce compression on the medial plantar nerve since the heel is very last part to contact the ground [4].

  • In a forefoot strike landing, stress is dissipated over a larger surface area of the foot, extremely limiting stress on the heel [5].

What About Orthotics for Sore Heels?

One study reported that removal of orthotics, especially removal of high-arched orthotics, reduced external compression on the medial plantar nerve [4], thus reducing heel pain when running.

Orthotics might be of less priority in forefoot running since physiological loads act differently on the foot as compared with heel striking. Not to mention, running barefoot or in minimalist footwear enhances tactile information, registering better perception of foot motions and improves neuromuscular control of pronation, which collectively keeps plantar pressures at bay.

More From Run Forefoot:

When Proprioception Turns Ugly – Find out the causes of proprioception dysfunction in runners.

Shod Runner’s Brain Wired Different than a Barefoot Runner’s Brain – Comparing how barefoot and shod running affects neuronal connections in the brain’s motor areas

Improve Balance – Discover how minimalist shoes make you sturdier when running.

Wobble Board Fun – Quick shortcut to improve ankle strength for forefoot running.

Forefoot Running Shoe Reviews – In search of that perfect running shoe for forefoot running? Run Forefoot’s forefoot shoe reviews has you covered!

Daily Deals on Barefoot Running Shoes (because proper running begins with the proper shoes):

Men’s New Balance 20v3 – Reg. 100, Now 55

Men’s Vibram FiveFingers Bikila EVO – Reg. 120, Now 95.93

Men’s Vibram FiveFingers KSO EVO – Reg. 90, Now 71.93

Men’s Vibram FiveFingers Spyridon MR – Reg. 120, Now 95.93

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[1]. Ker RF. 1996. The time-dependent mechanical properties of the human heel pad in the context of locomotion. J Exp Biol.199:1501–1508.

[2]. Ledoux WR, Blevins JJ. 2007. The compressive material properties of the plantar soft tissue. J Biomech. 40:2975–2981.

[3]. Nigg BM, Luethi SM, Denoth J. 1983. Methodological aspects of sport shoe and sport surface analysis. In: Matsui H, Kobayashi K, editors. Biomechanics. Champaign, IL: Human Kinetic Publishers; p. 1041–1052.

[4]. Peck et al. Neuropathy in runners. Clin Sports Med, 2010;29:437-457.

[5].Verdejo R, Mills NJ. 2004. Heel–shoe interactions and the durability of EVA foam running-shoe midsoles. J Biomech. 37:1379–1386

[6]. Rask M. Medial plantar neuropraxia (Jogger’s foot). Clin Orthop 1978;181: 167–70.

[7]. Smith J, Dahm D. Nerve entrapments. In: O’Connor F, Wilder R, editors. The textbook of running medicine. New York: McGraw-Hill; 2001. p. 257–72.

[8]. Snook GA, Chrisman OD. 1972. The management of subcalcaneal pain. Clin Orthop Relat Res. 82:163–168.


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Bretta Riches

"I believe the forefoot strike is the engine of endurance running..."

BSc Neurobiology; MSc Biomechanics candidate, ultra minimalist runner & founder of RunForefoot. I was a heel striker, always injured. I was inspired by the great Tirunesh Dibaba to try forefoot running. Now, I'm injury free. This is why I launched Run Forefoot, to advocate the health & performance benefits of forefoot running and to raise awareness on the dangers of heel striking, because the world needs to know.
Bretta Riches

P.S. Don't forget to check out the Run Forefoot Facebook Page, it's a terrific place to ask questions about forefoot running, barefoot running and injury. I'm always happy to help!

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