It depends. I know that this is a frustrating answer, but it really depends on the diagnosis and how your body responds to running.
In most cases, pain at the back of the heel is originating from the Achilles tendon and pain underneath the heel is originating from the plantar fascia. While tendon and fascia are not the same, both tissues respond to stress similarly. Applying more stress than they can tolerate may result in the development of pain, stiffness or injury. Taking it easy may help calm down the symptoms, but these tissues tend to become deconditioned quite quickly, so you may be in for a nasty surprise when you return to running.
Achilles tendon and plantar fascia injuries can take quite some time to resolve, and it's important to remain active to help facilitate the healing process and keep you sane. In fact, a research study found no negative effects associated with continuing exercising while treating an Achilles tendon injury.
So how do you work out how much running is safe?
We can use the visual analogue scale (VAS) to rate pain severity, where 0 is no pain, and 10 is the worst pain imaginable. Every person and pain experience is different, so this approach isn't perfect. However, it does give us a reasonable idea of how the symptomatic region is tolerating running.
Ideally, the pain will stay between level 0 and 3 on the VAS during and after running. The pain is allowed to reach level 5 on the VAS during and after running but should reduce to the pre-exercise level within 24 hours. Basically, a slight increase in pain as a result of running is usually safe and acceptable. Also, pain and stiffness should not increase from week to week (i.e. you shouldn't feel like the injury is getting worse).
If the pain is above level 5 on the VAS during or after running or takes more than 24 hours to reduce to the pre-exercise level, you're probably overdoing it. Try reducing the duration or intensity of your next run, or have more rest days between runs. If there is no improvement, it's time to consult a health professional for assessment and advice.
Most people expect to be told that they can't return to running until they're pain-free, so they're excited to hear that running can be part of the solution. If this approach sounds appealing, you need to do two things:
Consult a health professional interested in running injuries to work out what's going on and confirm that it's safe to run.
Monitor how your injury responds to running and use this information to modify your running training load.
If you're sick of heel pain and ready to get some help, contact us or book an appointment online today.
Author: Shaun Bergin