If I had a dollar for every patient who came to me complaining of “Heel Spurs” I would be rich.  Heel spurs are very commonly discussed and yet somehow they are very misunderstood. I’m going to try to shed some light on the matter:

First, I have to explain how any kind of bone spur forms, and for that we have to touch briefly on a law of the body called Wolf’s Law (one of these days I am going to devote a whole blog to Wolf’s Law…when I do, that link will be here).

To summarize quickly, Wolf’s Law states that the structures of our bodies adapt based on the types of stress to which we subject them. We think of our bones and cartilage as being a static structural framework that doesn’t change – but in actuality, our musculoskeletal system is being constantly remodeled and updated to accommodate our needs. Without delving into the technicalities, just think about it in the same way as your computer security software which is continually revising itself to deal with the most current threats to your system.

Windows-Updates-Available

What would you do if you were a volleyball player who kept banging your knees into the hard floor when you dove for the ball? Well, you would probably start wearing knee pads to protect yourself from bruises.

HC volleyball

But what if the soft, squishy knee pads weren’t enough protection for you? You would either stop being so hard on your knees or you would find some bigger, better, tougher knee padding.

Maybe something like this:

heavy duty knee pad

Or even this:

X heavy duty knee pad

Thrillingly enough, this is the same progression that your body goes through. If you repeatedly damage the same area, your body eventually decides that it is going to have to cushion that spot.  So it sends some fluid to the injury site (we call this swelling). This fluid response is intended to rush healing resources to the area and also to cushion the spot in order to prevent further damage. If at this point you notice a little bit of pain and swelling and you decide to stop whatever activity you were doing, then your body can usually deal with the problem and recover quickly.

Unfortunately, humans are stubborn.  We often don’t listen to this early warning signal and we just keep doing whatever it is that we were doing when the problem started. This moves us on to the next level. Just like the knee pads, we acquire bigger, tougher cushioning in the area of stress. This comes in the form of scar tissue. Thick, unorganized fibers of scar tissue cover the injury site in an effort to patch up the damage. This tissue is tough and not as flexible as the original structures. It protects by restricting motion. At this point you begin to notice that your joint is not working as well as used to – it feels stiff and sore and if you aren’t careful you can lose range of motion in the area.

If you ignore red flags # 1 and #2, there is still one last defense that your body can deploy to attempt to heal a repetitive injury zone. It can lay down extra layers of bone. Just like the hard shell on the last knee pad picture, your body forms a protective boney prominence to reinforce the structures that keep being damaged. This sounds like a good idea, and it works to a degree – but sometimes your body gets a little overzealous with the bone growth and you develop unwieldy lumps and bumps of bone in unfortunate places. These boney lumps are called bone spurs.

Bone spurs can occur anywhere in the body. But the ones we are talking about are in the heel of the foot. Hence the name Heel Spur. Most heel spurs are right in the bottom of the heel where the Plantar Fascia attaches. Many people form a type of bone spur on the back of their heels where the Achilles Tendon attaches.  These are sometimes called “Pump bumps”.

heel spurs and pump bumps

Now that we have gotten that much straight, I am going to give you the cliché message to “tune in next time to find out what happens”… In my next blog I will tell you about treatment options for heel spurs. In the meanwhile, if you think you are getting a heel spur – remember what I told you and stop doing damage to the area. Give it a rest!

Walk well.

Pictures “borrowed” from:

www.fixingaslowcomputer.com

http://athletics.houghton.edu/photo_gallery.aspx?gallery=4&path=wvball

www.wiggle.co.uk

www.aspen-international.com

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