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Plantar Fasciitis (Heel Spur)

Plantar fasciitis is the term commonly used to refer to heel and arch pain traced to an inflammation on the bottom of the foot. More specifically, plantar fasciitis is an inflammation of the connective tissue, called plantar fascia, that stretches from the base of the toes, across the arch of the foot, to the point at which it inserts into the heel bone. Overpronation is the most common cause of plantar fasciitis. As the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch, and puts added tension on the plantar fascia. Over time, this causes inflammation.

Also known as heel spur syndrome, the condition is often successfully treated with conservative measures, such as the use of anti-inflammatory medications, ice packs, stretching exercises, orthotic devices, and physical therapy. Note: Please consult your physician before taking any medications. In persistent cases, Extracorporeal Shock Wave Treatment (ESWT) may be used to treat the heel pain.

The Achilles tendon is the largest tendon in the human body and can withstand forces of 1,000 pounds or more. It also is the most frequently ruptured tendon, usually as a result of a sports injury. Both professional and weekend athletes may suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.


Achilles Tendonitis

Events that can cause Achilles tendonitis may include:

  • Hill running or stair climbing.
  • Overuse, stemming from the natural lack of flexibility in the calf muscles.
  • Rapidly increasing mileage or speed when walking, jogging, or running.
  • Starting up too quickly after a layoff in exercise or sports activity, without adequately stretching and warming up the foot.
  • Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort, such as in a sprint.
  • Improper footwear and/or a tendency toward overpronation.

Achilles tendonitis often begins with mild pain after exercise or running that gradually worsens. Other symptoms include:

  • Recurring localized pain, sometimes severe, along the tendon during or a few hours after running.
  • Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone.
  • Sluggishness in your leg.
  • Mild or severe swelling.
  • Stiffness that generally diminishes as the tendon warms up with use.
     

Treatment normally includes:

  • A bandage specifically designed to restrict motion of the tendon.
  • Taking nonsteroidal anti-inflammatory medication for a period of time. Note: Please consult your physician before taking any medication.
  • Orthotics, which are corrective shoe inserts designed to help support the muscle and relieve stress on the tendon. Both nonprescription orthoses (such as a heel pads or over-the-counter shoe inserts) and prescribed custom orthotics may be recommended depending on the length and severity of the problem.
  • Rest and switching to exercises that do not stress the tendon (such as swimming).
  • Stretching and exercises to strengthen the weak muscle group in front of the leg, calf, and the upward foot flexors.
  • Shockwave (EPAT/ ESWT)
  • Dry needling
  • Cortisone

In extreme cases, surgery is performed to remove the fibrous tissue and repair any tears.