What is a heel spur?

A Heel spur, often known as a calcaneal spur, is a bony protrusion that originates on the heel bone. Calcaneal spurs can occur at the back of the heel (dorsal heel spur) or under the sole of the foot (plantar heel spur). Dorsal spurs are frequently connected with Achilles Tendinopathy, whereas spurs under the sole are generally related to Plantar fasciitis.

WHAT ARE THE CAUSES?

A painful Heel spur is caused by improper biomechanics (excessive or abnormal pronation of the foot).

Due to long-term strain on the plantar fascia and foot muscles. for example- prolonged standing, calf, and plantar fascia tightness, high-impact exercises, or sports that involve running, jumping, or sudden movement.

WHAT ARE THE SYMPTOMS OF THE HEEL SPUR?

1. Sharp, stabbing pain beneath or inside the heel.
2. The pain is usually alleviated when you lie down but becomes worse when you get up.
3. Obesity may be regarded as a risk factor.

PHYSIOTHERAPY MANAGEMENT:

• Short-term pain alleviation can be achieved with the use of therapeutic orthotic insoles and footwear modifications.
• Achilles and plantar fascia stretching.
• Night splints.
• Cast or boot immobilization for some time.
• ESWT.
• TR therapy or TECAR therapy.
• Radiotherapy or Laser therapy.
• Cryotherapy or Cryoultrasound therapy.
• Thermotherapy, such as cold therapy to alleviate inflammation and pain, or heat therapy to relax tight muscles and increase oxygen and blood flow to the affected area.
• Therapeutic ultrasound therapy.
• Stretching- passive and active.
• Strengthening of the muscles of the legs.

Some examples of home exercise programs are:

Foot flex

1. Sit upright with your knee straight and your foot in front of you.
2. Pull your toes back toward your shin with your hand.
3. Hold this position for approximately 30 seconds.
4. Repeat two to three times on each side.

Calf stretch on a step

1. Place your right foot on the edge of a step, with your heel falling off the edge.
2. Slowly lower your heel as far as it will go.
3. Maintain this posture for 15 to 30 seconds.
4. Repeat with your left foot. Repeat two to four times on each side.

Toe towel grab

1. Put a little towel beneath your foot.
2. To grab the towel, curl your toes.
3. Raise your front foot off the floor.
4. Maintain this posture for a few seconds.
5. Lift your toes and spread them as far apart as possible while releasing the towel.

Wall calf stretch

1. Place your left foot in front of your right foot a few feet away from a wall.
2. Lean against the wall, gently bending your left knee.
3. Place your weight on your left foot slowly.
4. Lift your right heel off the ground while keeping your right knee straight. Feel the stretch along the back of your calf.
5. Maintain this posture for 15 to 30 seconds.
6. Repeat two to five times on each side.

Wall squat calf stretch

1. Get into a squatting position with your back to a wall. Your hips and knees should be in line, with your ankles directly underneath.
2. Lift both heels slowly off the floor.
3. Hold for a few seconds before returning your feet to the beginning position.
4. Perform 2–3 sets of 8–12 repetitions.

Golf ball roll

1. Place a golf ball beneath your right foot and roll it.
2. Continue for one minute.
3. Repeat for each foot two to three times.

MEDICAL MANAGEMENT:

• Non-steroidal anti-inflammatory drugs.
• Cortisone injections.
• Botulinum toxin (Muscle relaxer).

SURGICAL MANAGEMENT:

• Endoscopic plantar fasciotomy.
• In-step fasciotomy.
• Minimal invasive surgical technique.