What helps with heel pain and heel spur symptoms?

The pain most often occurs in the morning, at the back or side and when stepping on the foot. Although athletes such as runners or football players are most susceptible to heel pain , this discomfort also affects a large part of the general population. Most of us then try to find comprehensive information about why this pain bothers us and what causes it. Since we have also encountered it, we bring you a summary of basic information about the issue of heel spurs and plantar fasciitis, which you should know if you are deciding how to further treat the injury.

Heel pain in points:

1. Heel pain - in the morning, from below, behind, from the side , at rest , when stepping on , when walking , when running - can be caused by various factors, including inflammation of the Achilles tendon, plantar fasciitis, or the formation of a spur on the heel bone;
2. A heel spur is a small growth on the heel bone that can develop due to inflammatory changes in the plantar fascia;
3. Plantar fasciitis is an inflammation of the fascia on the foot, often the result of overuse. This injury can be associated with age, improper footwear, obesity, or intense sports performance;
4. Treatment for plantar fasciitis and spurs includes rest, stretching, massage, orthotics, medications, and in extreme cases, surgery. Stretching and massage can be done at home, but it is important to see a doctor for a proper diagnosis and treatment plan;
5. Recovery time varies from person to person, but most patients will experience pain relief within 10 months of starting treatment. Athletes should gradually increase their workload and return to training only after full recovery.

Why does my heel hurt?

If you were injured in a single hard impact , it is likely a fracture or injury to ligaments, muscles or tendons. If your pain has been developing gradually over weeks and has been getting worse , you need to be aware of where your heel hurts. Pain in the back of the heel is usually caused by inflammation of the Achilles tendon or inflammation of the bursa (bursitis). The cause of pain in the bottom of the heel is most often plantar fasciitis, which can even cause a spur. ¹

Source: www.mayoclinic.org

What exactly is a heel spur and plantar fasciitis?

A spur is a small growth on the bone . It most often occurs on the calcaneus of the heel bone. It usually measures around 1-2 millimeters and is very painful. A spur is very closely related to plantar fasciitis. ²

Why does plantar fasciitis occur?

Plantar fasciitis is not uncommon in older people, obese people, people with poor gait, people with inappropriate footwear and athletes . These groups of people have in common that they have exposed their feet (and therefore the plantar fascia) to excessive stress . When stress is applied, microtraumas occur. When the stress is reasonable, the tissues regenerate and become stronger and firmer. If the stress is excessive and we cannot regenerate the microtraumas, tissue degeneration occurs, which prolongs healing and causes pain. In the case of the sole, this is called plantar fasciitis. ³

How does plantar fasciitis lead to a spur?

The plantar fascia begins at the heel bone . When it is inflamed, it can even fuse to the beginning of the plantar fascia , causing calcium to be deposited in the area, creating a growth on the heel called a heel spur. ²

Source: www.orthoinfo.aaos.org

Typical symptoms and signs of a heel spur

Plantar fasciitis typically occurs in the morning when getting out of bed . Patients describe the pain as stabbing , localized purely in the foot and heel . The pain in plantar fasciitis improves with walking and activity , but after a longer rest it returns with the first movements . In a spur, the pain is similar to that in plantar fasciitis, but does not subside as easily with movement . Palpation of the bottom of the heel is also painful.

What to do about plantar fasciitis and a spur?

• If you suspect these injuries, you should of course visit a doctor (orthopedic specialist) who can confirm or refute the diagnosis.
• For plantar fasciitis, they will recommend rest for your foot, stretching of the fascia, and may prescribe orthopedic insoles , a brace , or medication.
• For a very painful spur, he will also recommend rest and will probably prescribe anti-inflammatory drugs such as ibuprofen, diclofenac, aulin, etc. He may also proceed to inject corticosteroids . Only after the acute phase of the disease has passed and the condition of the leg has stabilized a bit, it is reasonable to start stretching. One of the treatment options is the use of shock waves. If conservative therapy fails, surgery is necessary. ¹

Exercises for heel pain

• The most effective stretch seems to be directly on the plantar fascia . Cross your foot over the painful one (the one on top), grab your big toe, and pull it toward your shin for 15 to 30 seconds.
• You can also try a gentle foot massage , where you run your foot over a massage roller or perhaps a bottle or tennis ball.
• Calf stretches can also be helpful. In the classic position, lean against a wall, place your affected leg behind you, heel on the ground, and shin at an angle where your calf is stretched.
• Next, try pulling the toe of your foot towards you using a towel under the toe. ⁴

How long does the treatment take and how soon can I train again?

Each treatment is individual, depending on the patient's healing abilities and how early the injury was caught . Early-treated fasciitis can disappear in a few weeks. In 90% of all fasciitis and spurs (including the most severe ones), the pain is completely gone within 10 months of stretching and a light regimen. ⁵

As athletes, we are primarily interested in when we can fully return to training. There are no specific numbers for this. You need to perceive your body, start training gradually and lightly . The main thing is to wait until the pain goes away and you can put weight on your leg in everyday life. Then you can start trying to gradually increase the load and return to training. It is important to stick to the principles that you must not train through pain and leave enough space for regeneration between individual training sessions, preferably a few days. We all want to return to training as soon as possible, but in this case, patience pays off.

Resources:

1. Agyekum, Edward Kwame, and Kaiyu Ma. "Heel pain: A systematic review." Chinese journal of traumatology = Zhonghua chuang shang za zhi vol. 18.3 (2015): 164-9. doi:10.1016/j.cjtee.2015.03.002
2. Kirkpatrick, Joshua et al. "The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations." Journal of anatomy vol. 230.6 (2017): 743-751. doi:10.1111/joa.12607
3. Trojian, Thomas, and Alicia K Tucker. "Plantar Fasciitis." American family physician vol. 99,12 (2019): 744-750
4. https://www.healthline.com/health/fitness-exercise/plantar-fasciitis-stretches
5. https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs
6. https://www.vondt.net/cs/fibromyalgie-a-plant%C3%A1rn%C3%AD-fasciitida/