Heel Spurs HUB 

GENERAL HEEL SPURS INFORMATION HUB

Heel Spurs - What is it?


The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity The etiology of these spurs is a contentious issue and it has been explained through a number of theories including the degenerative, inflammatory, traction, repetitive trauma, bone-formers and vertical compression theories.




Heel Spurs - Are Heel spurs and Plantar fasciiitis the same thing?


No they ar not!!! It is very important to understand that these two things are entirely different condiions which ahve different treatments that should be engaged to enable rehabilitation. There are important distinctions between heels spurs and plantar fasciitis. A heel spur is a calcium deposit that forms a bony protrusion along the plantar fascia. In contrast, plantar fasciitis is a condition where the plantar fascia gets irritated and swollen, which causes pain in the heel. It is important to be able to differentiate between the two conditions to eb able to direct treatment. The Lower Extremity Group offers to you the Gold Standard in Lower extremity injury rehabilitation. We utilise a World Class rehabilitation program for Heel spur and plantar heel injuries, and this is deilvered to you online in the comfort of your own home. All you have to do is follow our easy to use evidence based plan to treat and manage your heel injury. This online program contains 4 complete weeks of revolutionary rehabilitation guides to help you manage and treat your heel injury issues every single day. We deliver our evidence-based daily heel injury management program via our amazing app, which is very easy for you to follow and includes 28 days of;

  • Progressive neuromuscular exercises that will strengthen the muscles around the foot and ankle and help reduce the pain associated with heelinjury.
  • 5 progressive levels of evidence based rehabilitation that do not require expensive equpiment
  • Passive and dynamic mobility exercises to increase range of motion and tissue extensibility of mucles and fascia
  • ​Myofascial massage exercises
  • Using the app will enable you to understand when to apply the various exercises to help manage heel injury
  • Plus more
We offer online consultations as a part of the rehabiliation precess to help you rehabilitate and manage your heel injury. ​Our experienced therapists have taken these aforementioned technical modalities and simplified them into easy to watch videos for you to follow and complete. These are delivered daily to your smart device within our heelinjury management program. Book in today - Online or in clinic




Heel Spurs - How do we manage Heel Spurs?


The Lower Extremity Group offers to you the Gold Standard in Lower extremity injury rehabilitation. We utilise a World Class rehabilitation program for Heel spur and plantar heel injuries, and this is deilvered to you online in the comfort of your own home. All you have to do is follow our easy to use evidence based plan to treat and manage your heel injury. This online program contains 4 complete weeks of revolutionary rehabilitation guides to help you manage and treat your heel injury issues every single day. We deliver our evidence-based daily heel injury management program via our amazing app, which is very easy for you to follow and includes 28 days of;

  • Progressive neuromuscular exercises that will strengthen the muscles around the foot and ankle and help reduce the pain associated with heelinjury.
  • 5 progressive levels of evidence based rehabilitation that do not require expensive equpiment
  • Passive and dynamic mobility exercises to increase range of motion and tissue extensibility of mucles and fascia
  • ​Myofascial massage exercises
  • Using the app will enable you to understand when to apply the various exercises to help manage heel injury
  • Plus more
We offer online consultations as a part of the rehabiliation precess to help you rehabilitate and manage your heel injury. ​Our experienced therapists have taken these aforementioned technical modalities and simplified them into easy to watch videos for you to follow and complete. These are delivered daily to your smart device within our heelinjury management program. Book in today - Online or in clinic





RECOMMENDED MEDICAL LITERATURE HUB

The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations Joshua Kirkpatrick et al


J Anat. 2017 Jun;230(6):743-751. doi: 10.1111/joa.12607. Epub 2017 Mar 29. https://pubmed.ncbi.nlm.nih.gov/28369929/ Abstract The plantar calcaneal spur (PCS) is a bony outgrowth from the calcaneal tuberosity and has been studied using various methods including cadavers, radiography, histology and surgery. However, there are currently a number of discrepancies in the literature regarding the anatomical relations, histological descriptions and clinical associations of PCS. Historically, authors have described the intrinsic muscles of the foot and/or the plantar fascia as attaching to the PCS. In this article we review the relationship between the PCS and surrounding soft tissues as well as examining the histology of the PCS. We identify a number of key associations with PCS, including age, weight, gender, arthritides, plantar fasciitis and foot position; these factors may function as risk factors in PCS formation. The etiology of these spurs is a contentious issue and it has been explained through a number of theories including the degenerative, inflammatory, traction, repetitive trauma, bone-formers and vertical compression theories. We review these and finish by looking clinically at the evidence that PCS causes heel pain.




Classification of Calcaneal Spurs and Their Relationship With Plantar Fasciitis Binghua Zhou


J Foot Ankle Surg. Jul-Aug 2015;54(4):594-600. doi: 10.1053/j.jfas.2014.11.009. Epub 2015 Mar 11. https://pubmed.ncbi.nlm.nih.gov/25771476/ Abstract Calcaneal spurs, as a cause of plantar fasciitis, are currently debatable. A prospective study was performed to classify calcaneal spurs according to the findings from an investigation of the relationship between calcaneal spurs and plantar fasciitis. Thirty patients with calcaneal spurs and plantar heel pain underwent calcaneal spur removal and endoscopic plantar fasciotomy. The relationship between the classification of calcaneal spurs and plantar fasciitis was evaluated by endoscopic findings, clinical symptoms, radiographic images, and biopsy findings. The visual analog scale for pain and the American Orthopedic Foot and Ankle Society ankle-hindfoot scores for functional evaluation were used preoperatively and postoperatively, respectively. The mean follow-up period was 24 months. Two separate types of calcaneal spurs were recognized. Type A calcaneal spurs were located superior to the plantar fascia insertion, and type B calcaneal spurs were located within the plantar fascia. Magnetic resonance imaging results showed a more severe plantar fasciitis grade in type B calcaneal spurs preoperatively. Histologic examination showed that the numbers of granulocytes per image in type B spurs were significantly increased compared with those in type A spurs. Statistically significant improvements were found in the mean visual analog scale and American Orthopedic Foot and Ankle Society scores and magnetic resonance imaging results in both groups. The amount of change in the visual analog scale score and American Orthopedic Foot and Ankle Society score, the number of granulocytes per image, and calcaneal spur length showed a high association with the classification of the calcaneal spurs. Calcaneal spurs were completely removed and did not recur in any of the patients on radiographic assessment during the follow-up period. Calcaneal spurs can be classified into 2 distinct types that are indicative of the severity of plantar fasciitis.




Why heel spurs are traction spurs after all. Johann Zwirner et al


Sci Rep. 2021 Jun 24;11(1):13291. doi: 10.1038/s41598-021-92664-4. https://pubmed.ncbi.nlm.nih.gov/34168232/ Abstract It is unclear whether plantar and posterior heel spurs are truly pathological findings and whether they are stimulated by traction or compression forces. Previous histological investigations focused on either one of the two spur locations, thereby potentially overlooking common features that refer to a uniform developmental mechanism. In this study, 19 feet from 16 cadavers were X-ray scanned to preselect calcanei with either plantar or posterior spurs. Subsequently, seven plantar and posterior spurs were histologically assessed. Five spur-free Achilles tendon and three plantar fascia entheses served as controls. Plantar spurs were located either intra- or supra-fascial whereas all Achilles spurs were intra-fascial. Both spur types consistently presented a trabecular architecture without a particular pattern, fibrocartilage at the tendinous entheses and the orientation of the spur tips was in line with the course of the attached soft tissues. Spurs of both entities revealed tapered areas close to their bases with bulky tips. Achilles and plantar heel spurs seem to be non-pathological calcaneal exostoses, which are likely results of traction forces. Both spur types revealed commonalities such as their trabecular architecture or the tip direction in relation to the attached soft tissues. Morphologically, heel spurs seem poorly adapted to compressive loads.




Relationship and Classification of Plantar Heel Spurs in Patients With Plantar Fasciitis Jamal Ahmad et al


Foot Ankle Int. 2016 Sep;37(9):994-1000. doi: 10.1177/1071100716649925. Epub 2016 May 13. https://pubmed.ncbi.nlm.nih.gov/27177888/ Abstract Background: This study classified plantar heel spurs and their relationship to plantar fasciitis. Methods: Patients included those with plantar fasciitis who were treated from 2012 through 2013. Plantar heel spur shape and size were assessed radiographically and correlated to function and pain before and after treatment. Function and pain were scored with the Foot and Ankle Ability Measures and a visual analog scale, respectively. This study included 109 patients with plantar fasciitis. Results: The plantar heel spur shape was classified as 0/absent in 26 patients, 1/horizontal in 66 patients, 2/vertical in 4 patients, and 3/hooked in 13 patients. The plantar heel spur size was less than 5 mm in 75 patients, 5-10 mm in 28 patients, and greater than 10 mm in 6 patients. Initially, patients with any shape or size to their spur had no difference in function and pain. With treatment, patients with horizontal and hooked spurs had the greatest improvement in function and pain (P < .05). With treatment, patients with larger spurs had the greatest improvement in function and pain (P < .05). Conclusion: Plantar heel spurs can be classified by shape and size in patients with plantar fasciitis. Before treatment, neither the spur shape nor size significantly correlated with symptoms. After treatment, patients with larger horizontal or hooked spurs had the greatest improvement in function and pain. These findings may be important when educating patients about the role of heel spurs with plantar fasciitis and the effect of nonsurgical treatment with certain spurs.





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GOLD STANDARD HEEL SPURS REHAB PROTOCOLS


The Lower Extremity Group offers to you the Gold Standard in Lower extremity injury rehabilitation. We utilise a World Class rehabilitation program for Heel spur and plantar heel injuries, and this is deilvered to you online in the comfort of your own home. All you have to do is follow our easy to use evidence based plan to treat and manage your heel injury. This online program contains 4 complete weeks of revolutionary rehabilitation guides to help you manage and treat your heel injury issues every single day. We deliver our evidence-based daily heel injury management program via our amazing app, which is very easy for you to follow and includes 28 days of;

  • Progressive neuromuscular exercises that will strengthen the muscles around the foot and ankle and help reduce the pain associated with heelinjury.
  • 5 progressive levels of evidence based rehabilitation that do not require expensive equpiment
  • Passive and dynamic mobility exercises to increase range of motion and tissue extensibility of mucles and fascia
  • ​Myofascial massage exercises
  • Using the app will enable you to understand when to apply the various exercises to help manage heel injury
  • Plus more
We offer online consultations as a part of the rehabiliation precess to help you rehabilitate and manage your heel injury. ​Our experienced therapists have taken these aforementioned technical modalities and simplified them into easy to watch videos for you to follow and complete. These are delivered daily to your smart device within our heelinjury management program. Book in today - Online or in clinic