Heel pain doesn't mean you stop running or training. Our fellowship-trained Doctors of PT diagnose the root cause — plantar fasciitis, Achilles tendinopathy, or stress fracture — and build a plan to get you back to full activity.
Common Diagnoses
Heel pain isn't just one thing. Click each section below to learn about the three most common causes we see in runners and athletes — and what to do about each one.
Plantar fasciitis is inflammation or degeneration of the thick band of tissue (plantar fascia) that runs along the bottom of your foot from your heel to your toes. It's the most common cause of heel pain in runners and active adults.
Plantar fasciitis is typically caused by repetitive load exceeding tissue capacity. Common contributing factors include:
We identify the root cause — weak soleus, poor hip power, or faulty mechanics — and build a progressive loading program to fix it. Most runners with plantar fasciitis can stay training with modifications while we rehab the tissue.
Achilles tendinopathy is a degenerative condition of the Achilles tendon — the thick cord connecting your calf muscles to your heel bone. It develops when the tendon is repeatedly loaded beyond its capacity to adapt and recover.
Achilles tendinopathy is a load-management problem. The tendon is being asked to do more than it's currently capable of handling. Contributing factors include:
Tendons heal with controlled load, not rest. We use progressive eccentric loading (e.g., heavy calf raises) to build tendon capacity while modifying your training to stay below the pain threshold. Most runners can continue training through Achilles rehab.
A stress fracture is a small crack in the bone caused by repetitive loading without adequate recovery. In the heel, stress fractures most commonly occur in the heel bone or the small bone in the middle of the foot. These are more serious than soft tissue injuries and require an X-ray or MRI to confirm.
Stress fractures occur when bone breakdown exceeds bone remodeling. Common causes include:
Stress fractures require relative rest from impact activities, but that doesn't mean full inactivity. We design cross-training programs (cycling, swimming, strength work) to maintain fitness while the bone heals. We also address the underlying biomechanical and training errors that caused the fracture in the first place.
Evidence-Based Resources
Heel pain doesn't mean you stop running. A Doctor of PT breaks down the root causes and gives you 3 evidence-backed exercises to keep training.
HYROX athletes push hard on sled pushes, wall balls, and runs. Here's how to keep your Achilles healthy through high-volume training.
Book a free 15-minute phone call with a Doctor of PT. We'll figure out what's going on and build a plan to get you back to training.