Did You Know That Heel Spurs Don’t Hurt?

Article submitted by Dr. Nicholas Sol of The Walking Clinic, PC. For further information he can be reached at 719-635-7700 or at www.TheWalkingClinic.com

The plantar fascia is a ligament-like structure on the bottom of our feet. It is thick, strong and fibrous. It’s a lot like gristle in a steak except this tissue is living tissue and that means it can respond. What do I mean by that? The best example is to imagine learning to play guitar. After a couple of weeks of practicing, you will develop callous on your finger tips from the pressure and rubbing on the guitar strings. That is the skin responding to repeated physical stress (i.e. pressure and rubbing) by becoming thicker to be stronger. All living tissues respond to repeated stress by becoming physically stronger. In most cases, the response involves thickening of the involved tissue.

In the case of the plantar fascia, the physical stress applied is neither pressure nor rubbing; it’s stretching. The plantar fascia is subjected to repetitive stretching injury because of its anatomic location: it stretches across the bottom of our feet. When our soft round feet bear our body weight against a hard flat ground, the plantar fascia is stretched. Sometimes it’s stretched beyond its ability to stretch and then some of the fibers tear. This begins the process of inflammation that ultimately causes pain and motivates patients to seek a doctor’s appointment.

If the stretching injury continues, another tissue will be forced to respond; the heel bone. Remember that most tissues respond by becoming thicker to become stronger. Skin adds skin and ligament adds ligament. How do you suppose bone responds? The heel bone (calcaneus) adds bone to strengthen the attachment of the plantar fascia and that creates a heel spur.

Now hold onto your seat... heel spurs don’t hurt. They never have and they never will. Even the latest surgical procedures leave the spur alone. If a spur is found on your heel it signifies that the stretching injury has been occurring for several years but the heel bone is usually not the injured tissue; the repetitive stretching has injured the plantar fascia.

Fortunately, surgery is rarely required. Standard initial treatment for plantar fasciitis is two pronged: we must treat what you have (inflammation) and we must treat why you have it (repetitive stretching). Either oral or injected anti-inflammatory is necessary for the inflammation. Custom orthotics are necessary for the repetitive stretching injury. Ironically, gentle stretching of the plantar fascia and Achilles tendon can also be helpful. Self-care can include rest, ice, compression and elevation (RICE) therapy.

Over the counter arch supports are often a rip-off that fit neither foot well. Some unscrupulous retailers sell these mass produced injection molded items for $50 to $300. Remember, no two feet are the same – not even your own. That’s why custom foot orthotics will provide maximum benefit especially if they have been prescribed and fitted by a Podiatrist.