In this article, we're going to look at how I answer the question, is my patient's heel pain from their body mechanics or their boots?
If you're considering not going to the mountain or reducing your skiing or riding time because of heel pain, read this article to learn more about your options. This is also a great article for any skiers and snowboarders wondering how to improve boot comfort.
The Beginning of Heel Pain and Why You Feel Pain During Skiing
Checking your boot and foot position in your skiing or riding boots can help you make sure you've set yourself up for success with your gear.
It's frustrating when you are getting ready to lace up and get outside knowing that your heel is going to hurt as soon as you stand up. Even worse, if you're like some of my clients, you know that even trying to get into your boots feels impossible and your heel is agitated before you even stand up.
How Does Heel Pain Affect Your Movement?
We see clients with heel pain start compensating what they are doing (aka a different part of your body tries to take on more of the work to avoid aggravating the heel pain further). This leads to more injuries and nagging pains in:
Calves
Knees
Hamstrings
Backs.
This is a common cause for people to give up healthy activities they enjoy. We've got no use for heel pain when we are climbing, trekking, or exploring, and if you don't address it, it will have an impact on your outdoor lifestyle.
Properly fitting your gear can be a much cheaper alternative than throwing away a good set of ski boots. Have you considered the basics of boot foot and your knee and ankle position before you go snowboarding or skiing in new boots? If not, watch this short clip to make sure you've asked yourself the basic questions.
Once you've looked at boot fit, you're at a good starting point to find the root cause of the problem. This is critical because heel pain can have several causes, and solving heel pain can help you keep up your active outdoor lifestyle.
You may have heard the saying "
When your foot hits the ground, everything changes". Well, maybe you haven't, but can you how imagine how your foot changes in response to putting weight on it?
I prefer the saying "When your foot hits the ground, the ground hits back".
You've got to be able to handle impact through your feet and heels when you're living an adventurous life. If you ask your body for too much before adequately training your strength and range of motion, you might be at risk for one of these 3 common types of heel pain,
A Deep Dive into the Causes of Heel Pain
The heel handles up to 3.5 times your body weight when running, can you imagine how a loaded pack headed up a rocky climb feels on your heel? (You can read more about how to properly load the foot here.)
At a Glance, there are 3 Distinct Classifications of Heel Pain:
Plantar Fasciitis: This is an overuse injury and very common. Generally indicated by a sharp pain in the heel. This typically feels very uncomfortable in the morning and tight but loosens up as the day goes on.
Achilles Tendonitis: This overuse injury is very common in skiers and is typically characterized by tightness, swelling, and stiffness around the ankle area.
Tarsal Tunnel Syndrome: This is a compression injury that shows up with pain, numbness, tingling, and burning sensation in the heel and foot. This can occur if your ski or snowboarding boots are too tight.
Let's Take A Closer Look Dive
Plantar Fasciitis
One of the most common causes of heel pain is plantar fasciitis. If you have heel pain, you've probably already looked this one up, or you already heard from so and so that they had this one time. It's really common.
The plantar fascia is a band of tissue that runs along the bottom of the foot from the heel to the toes. It can become irritated by overuse or strain and is often seen in people who are running or jumping. We see this commonly throughout the ski season, and at the start of the running season. It causes sharp pain in the heel, and the most common complaint is being very tight and uncomfortable during the first few steps of the morning, then loosening up during the day, and again becoming uncomfortable in the evening.
Achilles Tendonitis
Another common cause of heel pain is Achilles tendonitis. This is an inflammation of the Achilles tendon, which runs along the back of the heel and connects the calf muscle to the heel bone.
This also is caused by overuse or strain, and presents among all sports, with skiing and running again leading the way. Achilles tendonitis can also cause pain and stiffness in the heel, and deceivingly present as heel pain. Sneaky, sneaky.
Tarsal Tunnel Syndrome
Tarsal Tunnel Syndrome is a nerve compression along a narrow pathway along the inside of the ankle. This can cause heel pain, numbness, tingling, and burning sensation in the heel and foot, particularly right at the same painful spot as plantar fasciitis and Achilles tendonitis. This isn't as much of an overuse or strain injury, but instead, it's a compression injury, which means we do want to look out for anything compressing the area. Consider your ski or snowboard boots - specifically how tight they are around the ankles. (Check out more on your ski boot fit here)
Each of these three conditions can present in very similar ways, so understanding the nuances and looking closely at your lower leg symptoms and the way you would describe your pain is essential.
How to Handle Heel Pain
It can be frustrating when you're having pain that limits how you walk around the park with your family, or how you feel as you get ready for your first ski laps of the day.
So, What Can you Do?
Get a Professional Opinion
Seeing a professional can help you narrow down your treatment exercises and therapies for heel pain. If you're serious about making the most of winter, don't wait! A couple of sessions of physical therapy can make all the difference in you getting the most value out of your ski pass this winter
We have clients come in knowing they've had a history or slow onset of slight tension in their calf or foot, but they haven't addressed it how they should. Then one day as they ski fast to keep up with their kids, or they increase their running mileage, and then all of a sudden they feel a pull and pain when putting weight on that leg.
Don't let this happen to you! Waiting too long for appropriate treatment can put you at risk for more serious injuries that will force you to take time off.
At Snowbeast Performance, we can help our patients find relief from heel pain with exercises such as soft-tissue manual therapy, dry needling, Instrument-Assisted soft-tissue mobilization, cupping, ankle oscillations, and more combined. These are most effective when appropriate stretching and strengthening exercises.
If you're not able to seek an evaluation with a physical therapist, adding in specific mobility drills, strengthening exercises, and soft tissue work on your own will make a huge difference - The key here is knowing what exercises to add for different types of pain.
Guided Online Support
If you're looking for a comprehensive approach, our Ready for Winter program is a 6-week Ski and Ride Specific On Ramp designed to help you prepare for the mountain. This is an online program with exercises that follow one of our favorite formulas:
2 Weeks of Mobility
2 Weeks of Stability
2 Weeks of Strength
This program is a fully-structured walk-through of specific mobility, stability, and strength exercises designed to help your total body prepare for Winter, including specific emphasis on lower leg muscles which can help you avoid heel pain. This is available with True Coach programming for online tracking and pdf downloads to suit your preference.
Self-Myofascial Release and Ankle Mobility
One of the most powerful combinations to help find relief for heel pain is through using Self-myofascial release, SMR, and ankle mobility drills at home.
You'll want to subscribe to my Youtube Channel so you don't miss my newest video where I take a deep dive into how to identify the different parts of your lower leg and heel where you might feel pain.
If you are experiencing heel pain, it's important to find out why you are having it, and what specifically you can do to address your cause of heel pain.
Finding the root cause of heel pain helps you solve the problem faster, and with better long-term benefits, leaving heel pain behind when you head up to the mountain. #snowbeastperformance