CHARLESTON, W.Va. -- Dear Cindy,

I am a 50-year-old male and I do cardio (treadmill or stepper) for 40 minutes per day four to five days a week. I also run outdoors between 4 and 9 miles each time. During the past few months, I have experienced soreness and pain on the back of my heels. I take aspirin for the pain and it goes away after a few days. I have new running shoes but still get the pain. Any suggestions as to what is going on and how I can remedy this problem? -- Thanks, Rick

Dear Rick,

What's going on is too much of the same activity causing repetitive stress on the same muscles and tendons of your feet. When you run, your foot hits the ground about 1,500 times for each mile you cover. The heel and the tissues attached bear most of the force each time your feet strike the ground.

There are several reasons you could be experiencing pain in the back of your heels, but the most obvious would stem from overuse. Overuse injuries and the inflammation they cause are quite common when an athlete continues to do the same activity day in and day out.

For runners and walkers, there are a variety of factors that contribute to foot pain -- poor mechanics, arthritis, sudden increases in distance, poor-fitting or unsupportive shoes are some of the most common. Depending on your particular symptoms, your pain could be a result of any one of the following conditions:

Achilles' tendonitis: Achilles' tendonitis causes your Achilles' tendon to become irritated and painful. Many sports enthusiasts have felt this discomfort from overstressing calf muscles and their Achilles' tendon. This is common when an athlete, such as a runner, suddenly increases the frequency or intensity of their run. If left untreated, it can cause a tendon to rupture, requiring surgery to repair.

Symptoms: Pain at the back of the heel where the Achilles' tendon attaches to the heel. The pain typically becomes worse if you exercise or play sports, and it often is followed by soreness, stiffness and mild swelling.

Plantar fasciitis: When repeated stress is put on the feet, the plantar fascia is overloaded or overstretched. The plantar fascia is a band of connective tissue running from the base of the toes to the heel.

Symptoms: Intense pain running along the bottom of the foot, especially noticeable when you step out of bed in the morning. Discomfort eases as you walk and this band is warmed and stretched.

CHARLESTON, W.Va. -- Dear Cindy,

I am a 50-year-old male and I do cardio (treadmill or stepper) for 40 minutes per day four to five days a week. I also run outdoors between 4 and 9 miles each time. During the past few months, I have experienced soreness and pain on the back of my heels. I take aspirin for the pain and it goes away after a few days. I have new running shoes but still get the pain. Any suggestions as to what is going on and how I can remedy this problem? -- Thanks, Rick

Dear Rick,

What's going on is too much of the same activity causing repetitive stress on the same muscles and tendons of your feet. When you run, your foot hits the ground about 1,500 times for each mile you cover. The heel and the tissues attached bear most of the force each time your feet strike the ground.

There are several reasons you could be experiencing pain in the back of your heels, but the most obvious would stem from overuse. Overuse injuries and the inflammation they cause are quite common when an athlete continues to do the same activity day in and day out.

For runners and walkers, there are a variety of factors that contribute to foot pain -- poor mechanics, arthritis, sudden increases in distance, poor-fitting or unsupportive shoes are some of the most common. Depending on your particular symptoms, your pain could be a result of any one of the following conditions:

Achilles' tendonitis: Achilles' tendonitis causes your Achilles' tendon to become irritated and painful. Many sports enthusiasts have felt this discomfort from overstressing calf muscles and their Achilles' tendon. This is common when an athlete, such as a runner, suddenly increases the frequency or intensity of their run. If left untreated, it can cause a tendon to rupture, requiring surgery to repair.

Symptoms: Pain at the back of the heel where the Achilles' tendon attaches to the heel. The pain typically becomes worse if you exercise or play sports, and it often is followed by soreness, stiffness and mild swelling.

Plantar fasciitis: When repeated stress is put on the feet, the plantar fascia is overloaded or overstretched. The plantar fascia is a band of connective tissue running from the base of the toes to the heel.

Symptoms: Intense pain running along the bottom of the foot, especially noticeable when you step out of bed in the morning. Discomfort eases as you walk and this band is warmed and stretched.

Heel spur: While many people have heel spurs, not everyone experiences symptoms. When X-rays are taken it reveals a hook of bone protruding from the bottom of the foot at the point where the plantar fascia is attached to the heel bone. This is common in middle-age men and women.

Symptoms: Heel spurs create tenderness and pain beneath the heel that tend to worsen with time and are sometimes a result or complications of plantar fasciitis.

Bursitis: Bursitis is the inflammation of a bursa sac, which are the small, fluid-filled pads that cushion bones, tendons and muscles around your joints. Commonly found in the shoulders, elbows or hips, bursitis also can affect the heel.

Symptoms: Pain in the middle of the undersurface of the heel that worsens with prolonged standing. Pain at the back of the heel that worsens if you flex your foot up or down. It feels achy and stiff and may become swollen and red.

Of course, effective treatment relies on a proper diagnosis. This is where the advice of a medical professional is invaluable. They will want to know the details regarding pain, medical history and if the pain is worse at certain times of the day or after your activity. A podiatrist or physical therapist can evaluate your gait to determine if there is a mechanical cause for your heel pain.

They will examine your feet for other symptoms such as muscle weakness or a decrease range of motion. They may even want to check out your running shoes for excessive wear in specific areas of the shoe. This will give clues in terms of poor bone alignment or problems with the way your feet strike the ground during a run. X-rays may be necessary.

Generally, treatment will include rest, ice and some simple stretches if it is an overuse problem. Backing down the amount of miles as well as running on softer, more forgiving surfaces such as a cushioned track or grass can be helpful.

Instead of doing the same repetitive activity in the gym, change it. Get off the treadmill and stepper and start doing some strength training for the upper body and core. Or, if you are running on pavement outside, bring your workout inside on a treadmill or stepper and add strength training to your regimen.

An initial assessment tells me you are doing too much of the same activity. Give your heels a break and start stressing a few of your other joints and muscles. Your feet will thank you.

Cindy Boggs, fitness presenter, author and Activate America director, has been an ACE-certified instructor/trainer since 1989. Send your questions about fitness, training or health to her at YMCA of Kanawha Valley, 100 YMCA Drive, Charleston, WV 25311, or e-mail cindys...@aol.com. Look for Cindy's award-winning fitness advice book, CindySays ... "You Can Find Health in Your Hectic World," on her Web site, www.cindysays.com, or contact the YMCA at 304-340-3527.