My question is not original, but hopefully your answer is: as a runner, I have suffered more and more from heel spurs in the right foot over the years. I used to run 10 kilometers every day and participate in competitions. I am 72 years old and healthy. I’ve tried everything: insoles, shockwave, cortisones, new sports shoes, consultations with a podiatrist and sports doctor. I have stopped running, but since 9 months I also have problems when I just walk. Do you know of an effective treatment?
Hans
Sepp Mortelmans, podiatrist
Heel pain, or heel spurs, is the most common complaint in the feet. However, heel spurs are not always the cause.
These are the most common causes of heel pain:
Calcaneodynia
The fat pad, which is located under the heel, provides good cushioning while standing and walking. But this fat pad loses some of its function as we age. This means that the fat pad becomes thinner and the cushioning capacity decreases, which can overload or irritate the heel bone.
heel spurs
A heel spur is an outgrowth of bone tissue on the heel bone in the shape of a curved spine. A heel spur is often located where the tendon plate attaches to the heel bone. This can be demonstrated with X-rays. If no abnormalities can be found on the X-ray, then there is more likely an irritation or inflammation of the tendon plate. The pain site of a heel spur can often be indicated with one finger.
This tendon (fascia) runs towards the toes and fans out to the heads of the metatarsal bones. It supports the longitudinal arch of the foot at the height of the sole (plantar) and, as a tensioned band, increases the push-off force of the foot during running and jumping. The tendon blade is not very elastic, because otherwise the foot would sag considerably when standing and the gait would be disturbed. A tendon plate inflammation (plantar fasciitis) is usually caused by too much tension on the attachment of the tendon plate under the foot.
Tendonitis
During (running) running, the tendon blade is tightened with every step. It is therefore not surprising that with a change in the gait cycle due to deviations in position, soft, flexible shoe soles and walking on uneven or hard terrain, this tendon can become inflamed. In this condition, the pain is located along this tendon leaf and on the inside of the heel bone.
Heel pain also often occurs when the foot is landed flat after a jump. The natural shock absorption of the foot is gone, so that the heel and the tendon plate absorb the ‘blow’ and are overloaded.
Complaints heel spur and tendon plate inflammation
It is sometimes difficult to distinguish these complaints from each other, because they have almost the same symptoms and manifest themselves in the same place. Usually there is a sharp pain when standing and a burning or aching and stiff feeling in the heel and through the foot. Morning stiffness and stiffness after rest are characteristic, as with many tendon infections, as is the starting pain during the first few meters of walking. Depending on the severity, pain will also be experienced while walking.
Frequently used treatments are indeed arch supports, shockwave and corticosteroid injection. If all this doesn’t work, I’m afraid I can’t do much for you. It is best to discuss this again with your doctor.
Do you also have a question? Then ask one of our experts. Always go to your doctor with urgent questions, the experts are not the right person for that. Nor do they make diagnoses. You can find the other conditions here.
Sepp Mortelmans is a podiatrist. He is a specialist in the field of ultrasound and foot complaints as a result of rheumatism. You can ask him questions about foot problems in general and his field in particular.