heel spurs

Heel spur syndrome (plantar fasciitis) is a common pain complaint under the heel.

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ANATOMY

The plantar fascia is a tendon plate attached to the heel bone on one side and the forefoot on the other. This fascia ensures that the arch of the foot is supported during the unwinding of the foot.

When the foot is on the ground, a very large force is exerted on the plantar fascia (the weight of the body presses on it). When the arch of the foot wants to sag because of this weight, this force stretches the plantar fascia. (Similar to tensioning a bow in archery.)

This 'stretching' leads to great tension at the attachment of the plantar fascia to the heel and can lead to fiber damage. Normally, these damages repair themselves during rest.

When this process of damage and repair continues to repeat itself, a deformity of the heel bone can occur. The body itself tries to ensure that the fascia remains in place. This growth is called a heel spur and is visible on an X-ray.

 

WHAT ARE THE CAUSES?

Sometimes the growth of the heel bone (the heel spur) is so great that it causes complaints. However, this rarely occurs. Pain complaints are more often caused by a chronic inflammation of the plantar fascia (this is called plantar fasciitis).

As people get older, the fat pad under their feet gets thinner. As a result, the shock absorption under the heel will decrease and greater pressure will be created there.
In addition, the following causes and/or combinations of causes may play a role in the development of the complaints:

• shortened or stiff muscles;

• overload, e.g. too much walking/exercise;

• walking on 'wrong' footwear;

• (minor) deviations of the feet
  (for example, hollow feet or kink or flat feet);

• leg length difference;

• overweight.

 

WHAT ARE THE (PAIN) COMPLAINTS?

The pain complaints are mainly under the heel; people often have starting pains after rest (eg in the morning or after sitting for a while). After long walking, the complaints can (again) arise / worsen.

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WHY DO I HAVE THE MOST COMPLAINTS IN MORNING AND AFTER REST?

When the tendon is not loaded, the blood flow in the tendon will decrease and the tendon will become less elastic. Due to this decrease in elasticity, the tendon will be hard and stiff when loaded (again). When the blood flow returns
is enlarged, for example by walking, the tendon will become more elastic and the complaints will decrease again.

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WHAT CAN WE MEAN FOR YOU?

If the (sports) podiatric examination shows that there is a cause in the foot position and/or the walking pattern, we have the following treatment options:

• Mobilization foot and/or leg
  To improve the mobility of the foot and/or leg.

• Taping
  To get immediate pain relief, the foot can be taped.

• Insoles for everyday use and/or sports
  To optimize foot position and gait.

• Shoe advice
  The sports podiatrist can give specific (sports) shoe advice.

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HOW LONG WILL IT TAKE FOR THE PAIN COMPLAINTS GO AWAY?

Often, when using podiatric soles, the complaints are quickly greatly reduced. Walking barefoot or on shoes without support can cause a relapse. On average, it takes 6-9 months for the pain to disappear completely.

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