Heel pain and heel spurs are two of the most common forms of foot pain. The two structures involved are the plantar fascia and the flexor digitorum brevis muscle. Both connect the calcaneous (heel bone) to the ball of the foot. Most heel pain, including heel spurs, occur due to plantar fasciitis. Most commonly the pain is felt at the heel where the arch meets the heel.
The heel bears all body weight in walking. Without protection under the plantar fascia and flexor digitorum muscle (more commonly called the arch), the structures pull and tear to the point they become extremely stiff. When they are too stiff and inflexible, the foot cannot functionally take a step without causing extreme distress in the heel and/or arch.
A spur develops when muscle tension on the flexor digitorum pulls a piece of bone away from the calcaneous. On x-ray, it has an appearance of a fishhook (see x-ray above).
If the symptoms are in a young boy, generally ages 8-17, see the section “Sever’s Disease”.
Other names or similar foot conditions:
- Plantar fasciitis
- Post static dyskinesia
- Sometimes mistaken for Achilles tendonitis or in conjunction with it
Symptoms:
- Heel pain – ranges from “mild toothache” in intensity up to being unable to bear weight
- Pain is worse upon taking the first step on waking or after sitting for a period of time
- There can be arch and forefoot pain also. However, there may be only heel pain
Signs to look for:
- Heel pain
- Pain that is worse upon taking the first step on waking or after sitting for a period of time
- X-ray can show heel spur
Possible Causes:
- Wear and tear over time, even if the pain seems to appear fairly suddenly
- Lack of support in the arch, combined with body weight, stretches and pulls on the arch structures to the point they cannot properly move the foot with tearing at the calcaneous
Goals:
- Take pressure off the heel
- Support the arch structures
- Regain flexibility and elasticity in the arch and ankle structures
- Move the foot forward with as little lateral movement as possible
How We Help:
Arch Supports:
- BioOrthotic exercising support with metatarsal lift
- Lower and thinner arch support with longitudinal and metatarsal support for use when shoes cannot accommodate the BioOrthotic exercising support
Shoes:
- Extra depth, double or triple depth shoe with high toe box, firm heel counter, rocker sole and connecting shank
- Smart footwear such as heel to toe rockers, negative heel shoes or shoes with titanium springs
- If regular flip-flop wearer, wear only the Orthaheel, Alegria or Aetrex brand
- Wear pumps and high heels only as long as absolutely necessary
- Avoid going barefoot or do so on a minimal basis only
Other:
Avoid using heel cups – the cure is in the arch
Activities:
- Regular stretching program of gastrocnemius and soleus muscles, Achilles tendon and arch structures
- Rotate weight bearing recreational activities with non-weight bearing activities, such as walking and racquetball (weight bearing) with swimming and biking (non-weight bearing)
This information does not constitute a diagnosis of your condition and does not take the place of a doctor’s care. The information has been compiled from sources available to the general public and referenced below. Copyright 2005-2010 Carole Romig
Sources Image: 1physiotherapy.com, Spinalphysio.Kornberg.net Text: PodiatryChannel.com, J. Vonhof, Fixing Your Feet