Q+A: My rigid orthoses give me heel pain. Help!

Q After repeatedly suffering from injuries, I was prescribed some rigid orthoses. The good news is that none of my old injuries has returned, but the bad news is that I can’t run more than 20 miles a week because of a tender heel. It’s worse in the morning, but eases as I move around – what’s the problem?

A It sounds as if the heel pain that you are suffering is due to your rigid orthoses. It seems likely that you simply have some bruising to the area under the heel – though the pain could be the result of the start of an inflammation of the attachment to the plantar fascia (the band of tough connective tissue running from your toes to the heel).

If the latter is the case, it could develop into full-blown plantar fasciitis. This is often extremely painful in the morning for 5-10 minutes, but eases as you walk on it, something that you allude to. If so, try massaging the tender area with ice, and resting until the pain eases. This will hopefully prevent the condition worsening.

If, however, it’s just bruising, the solution lies in adding some cushioning to your orthoses. Try to get each one covered with a soft material about 4mm in thickness, such as Poron or those made by Spenco. Your podiatrist should be able to organise this for you. Failing this, most running shops will have a similar material, which will sit on top of the orthoses as you run. If the symptoms do not settle, return to your podiatrist for further advice.

Simon Costain, consulting podiatrist