Heel Spurs

Considered a repetitive stress condition in which your fascia experiences wear and tear at the weakest point, where it attaches to your heel bone. Every time your foot strikes the ground your plantar fascia is stretched. Forces in your foot strike can reach 2-3 times your body weight depending on if you are standing, walking, running or jumping.

This extra tension can result in overstretching, inflammation and/or micro-tearing of the fascia at your heel which your body finds difficult to repair. As your body tries to heal itself, a heel spur or osteophyte (bony outgrowth or calcium deposit) develops around the bottom and/or the back of your heel (associated with Achilles tendonitis), which protrudes into the soft tissue. It can vary in shape from a flat, shelf-like growth to a hook-shaped, pointy projection, and can extend forward up to a half inch. Your body hopes this extra bone and tissue will help to relieve the pressure on your plantar fascia. Heel spurs can affect your ability to do your usual work and/or activities, and can also trap and irritate the nerves in your heel area. They can change the way you walk, and can lead to knee, hip and low back injuries. If severe, they may require medical intervention.

Heel spurs affect 10-21% of the population, and are most frequently seen in athletes, people who are on their feet all day, are overweight and/or over 40 years of age.

Many people refer to plantar fasciitis and heel spurs as one in the same. Although these are similar, they are not same. Heel spurs can actually be caused by plantar fasciitis; 50% of people with plantar fasciitis have heel spurs, whereas 19% of people have heel spurs without plantar fasciitis.

Alternate names and/or associated conditions:

Pump bump, exostosis, calcaneal spur syndrome, heel spur syndrome, Haglund's deformity

Causes

Your plantar fascia is only able to stretch to 102% of its length without tearing; therefore it doesn't have much flexibility when exposed to excessive weight or heel pounding. The main cause of this condition is from overuse and overloading in occupations where you are on your feet all day (teachers, store clerks, soldiers, waitresses, hostesses), activities that require you to push heavy items (shippers and receivers, construction workers) and/or sporting activities in which you overexert yourself (doing too much, too fast and/or too soon), especially running, football, baseball, basketball, tennis, volleyball, step-aerobics, stair climbing, dancing.

Poor biomechanics (abnormal twisting of your foot) affects the way your foot hits the ground. If you overpronate (feet rolling inward) you tend to have a low arch and flat foot (pes planus), which increases pressure on your plantar fascia. If you underpronate (feet rolling outward) you tend to have rigid feet and a high arch (pes cavus), which results in a shortened plantar fascia.

Faulty foot structures (abnormal growths, different leg lengths, and unhealed injuries) and muscle imbalances (tight, weak or shortened muscles in your foot, ankle, calf and hamstring) can cause you to walk on your toes which increases the strain on your plantar fascia and the muscles on the sole of your foot (flexor digitorum brevis and quadratus plantae).

Regular shoes or high heels that are too tight or don't support your heel or arch affect the distribution of your body weight on your foot and add undue stress to your plantar fascia and back of your heel. This causes a lot of rubbing and pressure points on your foot.

Health conditions such as obesity, inflammatory diseases (rheumatoid arthritis, ankylosing spondylitis), bursitis, neuroma (nerve growths), gout, diabetes, Haglund's deformity, and Achilles tendinitis can also instigate the problem.

Symptoms

You may or may not experience any symptoms with your heel spurs. It is normally the inflammation felt in the tissues around your heel spur that cause discomfort.

Heel pain is one of the first things you may notice, especially when pushing off the ball of your foot (stretches the plantar fascia). This can get worse over time and tends to be stronger in the morning, subsiding throughout the day; although it does return with increased activity.

A sharp, poking pain in your heel that feels like you're stepping on a stone can often be felt while standing or walking. You will sometimes be able to feel a bump on the bottom of your heel, and occasionally bruising may appear.

Diagnosing

Your doctor will take your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility, stability, and gait (the way you walk). Occasionally an x-ray (check for arthritis, bone spurs and joint inflammation) or blood tests (rule out diseases or infections) may be requested.

Treatment and Prevention

Heel spurs are considered a self-limited condition, which means that by making small alterations in your lifestyle and regular routines you can often control the condition. The goal is to relieve pain, reduce friction and transfer pressure from your sensitive foot areas. Failure to see improvements after conservative treatments may make surgery your only option.

Cold Compression Therapy

Rest and activity modification are among the most important things you can do to help recover from your heel spurs. Cold and compression will help to ease your pain and discomfort from inflammation. A Freezie Wrap^® is the best option to receive this type of treatment. The adjustable wrap allows you to control the compression to a level that is comfortable for you and the gel packs are chilled in the fridge not the freezer. This eliminates the risk of cryoburn, or 'cold burns', on your skin that can be cause by ice and freezer gel packs. You can also wear the Plantar/Spur Freezie Wrap^® for longer treatments so you can enjoy even more relief from your plantar pain.

Our Plantar/Heel Spur Freezie Wrap^® provide deep cold therapy in an easy to use wrap. We have noticed over time that our customers are so fond of our cold wraps that they are frequently coming back and ordering a second one - this way they can cool one while wearing the other. The wraps are becoming very popular with baseball and soccer trainers, and the wraps can be conveniently stored in a cooler for quick application on the field when needed.

Ultrasound Therapy

Ultrasound therapy is a great option to decrease inflammation, pain, tension and soft tissue (muscle, tendon, ligament, nerve and connective tissue) damage experienced with heel spurs. By using a therapeutic ultrasound device at home or by seeing a physiotherapist. The treatment is easy, painless, safe, and generally requires between 5 - 10 minutes. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). These waves send vibrations deep into your body and raise the temperature of your soft tissue. The waves are delivered through a hand held transducer and medicinal conductive gel that are used together in a slow, circular motion on your skin over the injured area. You may experience a slight tingling or warm sensation during the process as a result of the gel; this enhances the therapeutic effects of ultrasound through a process known as phonophoresis.

Ultrasound therapy increases collagen and tissue elasticity, which in turn promotes blood flow (circulation) and brings oxygen and nutrients to your tight foot muscles and tendons. This cleans your tissue by getting rid of cell waste products and helps your injury to heal. If not treated properly injured tissue can heal with a weakened state, which can lead to scar tissue or further calcification. If used on an ongoing basis, ultrasound will help to improve your range of motion and will break down any scar tissue or calcifications that may form in your foot area. Ultrasound waves penetrate deep into your tissues, relax your muscles and tendons, decrease chronic inflammation and accelerate your recovery rate, so you can return to your daily activities as soon as possible.

Blood Flow Stimulation Therapy

A Plantar Inferno Wrap^® is one of the most helpful tools for a heel spur. Through the absorption of high energy waves, tissues are safely and gently heated - stimulating blood flow within the heal. Your body's natural response to this increased temperature is to try to maintain a condition of homeostasis - a balanced environment or state of equilibrium throughout the body. To do this, your body responds with a rapid increase in blood flow to the area, increasing the supply of nutrients to injured cells and flushing out toxins to promote healing. Our Plantar Inferno Wrap^® provides effective, non-invasive, non-addictive pain relief with no side effects.

Other Conservative Treatments

Properly sized comfortable footwear (leave a 1/2 inch space between longest toe and inside of shoe) with significant arch support and motion control. Also, avoid running around barefoot, or on hard and uneven ground.

Corrective footwear, orthotics (insoles and arch supports) or other foot devices (walking casts, night splints) provide support and alignment.

Cushioning or supportive items, such as taping or donut-shaped heel cushions protect, reposition your foot, and relieve pressure pain.

Exercises that stretch and strengthen your foot (flexor digitorum brevis and quadratus plantae), ankle (achilles tendon) and leg muscles (soleus, gastrocnemius, hamstring) keep you balanced and flexible.

Gentle foot massage helps relax tissues; physio therapy, chiropractic care, reflexology and acupressure are effective in relieving tension, strengthening your foot and helping with alignment.

A balanced diet keeps your weight maintained.

Extracorporeal shockwave therapy, corticosteroid or Botox injections have been used, but must be administered by a medical professional and involve some risks. Multiple steroid injections should be used sparingly as they weaken the plantar fascia and lead to a rupture.

Pain and anti-inflammatory medications can help relieve some aches and pains.

Heel or plantar fasciitis surgery (endoscopic plantar fasciotomy, open heel-spur fasciotomy) helps to relieve pressure, reduce pain and remove the calcium spur from the heel area. However, surgery is not a guarantee and there can be complications. If the plantar fascia is not repaired when the heel spur is removed, it is likely it will return.

Recovery from heel spurs can take between 6 weeks - 18 months, depending on the severity of your condition and your commitment to proper rehabilitation. The more dedicated you are with your treatments, the faster you will see successful, long-lasting results.

See Plantar Fasciitis for more detailed information.

Or email us at service@AidMyPlantar.com