Heel Pain Caused by Plantar Fasciitis and Heel Spurs
There are many forms of foot pain, but heel pain can be one of the most troubling. The most common form of heel pain in individuals is known as heel spurs or plantar fasciitis. Many resources label them one in the same, however heel spurs and plantar fasciitis are slightly different.
Plantar fasciitis occurs when the long, flat ligament on the bottom of the foot (plantar fascia) stretches irregularly and develops small micro tears that cause the ligament to become inflamed. The pain is described as being dull, aching, or sharp and can be reproduced by flexing the toes upwards (dorsiflexion) and tensing the fascia.
A heel spur is actually a type of bone growth that develops on the outside of the heel bone where the plantar fascia ligament attaches. Spurs may form when the plantar fascia becomes inflamed causing calcification or bone growth. They are often described as having a small hook shape to them, which causes pain by irritating the surrounding soft tissue.
Although the plantar fascia is invested with countless sturdy “cables” of connective tissue called collagen fibers, it is certainly not immune to injury. Middle aged, overweight, and athletic individuals are more prone to plantar problems, as are non-athletic people who spend a lot of time on their feet or suddenly become active after a long period of lethargy. A recent study found that over 50 per cent of people who suffer from plantar fasciitis are on their feet nearly all day.
Plantar fasciitis and heel spurs usually develop gradually. Heel pain may only occur when taking the first steps after getting out of bed or when taking the first steps after sitting for a long period of time. If the plantar fascia ligament is not rested, the inflammation and heel pain will continue to get worse. Other conditions or aggravating factors, such as the repetitive stress of walking, standing, running, or jumping, will contribute to the inflammation and pain. In some cases, the inflamed ligament may not heal because individuals who are developing the conditions do not completely stop the activity aggravating the symptoms.
A number of factors are directly associated with development of plantar fasciitis and heel spurs. These factors can lead to the change of the gait (the way the feet strike the ground), which may cause additional injury. Risk factors for include:
• biomechanical factors, such as decreased flexibility in the foot and ankle, imbalances in muscle strength (muscles in one leg or foot are weaker than the other), abnormal foot mechanics (when stepping down), and tightness in the achilles tendon.
• the repetitive nature of sports activities and improper training.
• sudden increases in weight.
• rapidly increasing the length of time spent on the feet.
• running or walking up steep hills.
• wearing shoes that are worn out.
• wearing shoes that do not have a cushioned sole or enough arch support.
• abruptly changing the intensity or duration of athletic activities.
The traditional remedies for plantar fasciitis include application of ultrasound, stretching and stripping out the calf, chiropractic adjustments to the talar and sub-talar joint, potentially decreasing one’s activities, purchasing better-fitting shoes (with a raised heel and arch support), icing the sore heel, and taking a natural anti-inflammatory. Another common consideration is custom orthotics.
If you believe you are suffering from the above condition, please consider booking an assessment with myself or Dr. Tisshaw.
Have a great weekend,
Dr. Crysta Serné
Vancouver Chiropractor and owner of Vitality Clinic