Heel Spur (Plantar Fasciitis)

Plantar fasciitis is the most common cause of heel pain.  The plantar fascia is a thick band of tissue in the sole of the foot.  The function of this tissue is to help support the sole of the foot when the heel rises from the ground.  When mecahanics  are altered, the tension on this tissue can be increased.  When this occurs tearing of the tissue can occur on a microscopic level and if sufficient can result in a great deal fo pain.  The interface of the plantar fascia at the heel bone is the most common sit of injury and pain.  When tearing occurs at the origin of the plantar fascia on the heal bone, inflammation occurs resulting in pain.  A change in activity level and the associated change in calf muscles tone is the most common cause of plantar fasciitis.  The condition then becomes subject to the individuals activity level and body weight.

Symptoms:
The most notable symptom is pain with the first few steps in the morning or after periods of inactivity.  The pain is located in the heel and can be sharp.  It often improves after several steps or stretching.

Diagnosis:
Plantar Fasciitis is generally a clinical diagnosis, however, x-rays can be very helpful in determining other conditions contributing to or causing  the pain. Your orthopaedic surgeon will perform a clinical evaluation that includes evaluating posture, hip rotation and gait pattern, as subtle irregularities in these areas may be playing a role.

Treatment:
The vast majority of cased are treated non-operatively.  The main element of this treatment is calf stretching.  Regular daily stretching of the calf will improve ankle motion and alleviate the tension causing the injury to the plantar fascia.  The ”runners stretch” performed by placing the foot flat on the floor with the knee straight and leaning forward while supporting the upper body on a wall, chair back, counter top or the like.  The stretch is held for 10 to 15 seconds for 10 to 15 repetitions, performed a minimum of three times per day.  As the gastrocnemius muscle becomes more supple the ankle moves more freely and the stress on the foot decreases.  Progress is slow and one should not become discouraged as improvement may not be appreciated for 6 to 8 weeks.  If symptoms do not resolve after 6 to 8 weeks of consistent calf stretching, your orthopaedic surgeon may suggest other treatment options.

Return to Procedures