Q+A: How can I run with a painful heel spur?

Q I’m a flat-footed overpronator, and for a long time I suffered from a painful and stiff right heel. I had an operation called a heel trim and the problem cleared up. But now I seem to have the same problem in my left heel. My local hospital no longer carries out heel trims, and my foot is so painful that I fear I’ll have to give up running. Is there anything I can do?

A From the description of your symptoms (stiff heels) and the operation you underwent (heel trim) it sounds as though your problem centres around the back of your heels and Achilles tendons.

When you overpronate, the natural inward rolling of the foot is excessive. This means your heels will be everted rather than straight. This can increase strain on the Achilles tendon, and may eventually result in a build-up of bone around the insertion of the tendon into the heel bone. This build-up can be trimmed away – as you had done on your right heel, but it is unlikely that this would result in a complete resolution of the condition unless the overpronation is controlled. If your local hospital no longer carries out heel trims, the operation may be available elsewhere, but you should look at other options before contemplating further surgery.

The first question to address is whether you’re wearing the correct shoes. Serious overpronators should look for motion control shoes or stability shoes with firm midsoles and control features to reduce pronation, and should avoid highly cushioned, highly curved shoes.

Your problem is by no means uncommon, and usually responds well to prescription orthoses, so consider having a podiatrist carry out a full biomechanical assessment.—David Holland, consulting podiatrist