If you read my last post, you now know all about how a heel spur is formed. But what you still don’t know is what to do if you have one.  So let’s talk about treatment.

The most common treatment for heel spurs is to place a little squishy gel pad in your shoe. This is a good place to start – it can’t do any harm and it’s a pretty cheap fix. A word of advice: if you are going to bother putting a gel pad in your shoe, make it a heel cup not just a flat thing that sits under your foot. Here’s why:

You actually have a fat pad under your heel that was intended to provide cushion for your foot. (You can read all about it here ). The whole point of a heel cup is to contain that fat pad and push it back underneath your heel so that it can do its job.  Then on top of that, you get the additional cushioning provided by the actual material of the heel cup itself. If you just get a flat heel pad – then you don’t have the added benefit of using your body’s natural cushioning system, you only get the protection of that skimpy little piece of insole. And that is rarely enough.

Here are some of my favorite heel cups:

tuli heel cups

and

Mc D heel cups

Notice how they both have deep sides that really hug the heel? That’s what we are looking for. Not this:

crappy heel cups

Ok. Now that we’ve gotten that straightened out – we need to go a little deeper. Remember, I said that heel cups are the place to start. They are not the end all and be all of heel spur treatment.

One thing you have to understand is that heel spurs are not all that different from Plantar Fasciitis.

heel spurs and pump bumps

In fact, they are so closely related as to be almost indistinguishable.  The above picture was in my last post, it shows the areas where a heel spur can form.  Please notice that both locations are also the attachment sites of the Plantar Fascia and the Achilles Tendon. This means that pain in those areas could be from either the connective tissue itself or from the bone to which it attaches. But here’s the deal: it doesn’t really matter.  You are going to treat it exactly the same way. You need to eliminate the stress in the area and give it chance to heal.

1st you have to reduce the pulling stress:

Fascia tension

Pulling stresses occur when the attachment sites of tendons are under too much constant tension, this can cause little microscopic pieces of bone to be pulled off.  As you can imagine, your body does not appreciate this pulling stress and it decides to put a stop to it by reinforcing the area with extra bone – eventually forming a spur.

Eliminate pulling stress by stretching the muscles in the area. And I don’t mean stretching them once or twice, I mean that you have to stretch thoroughly and often in order to solve the problem.  Key areas to stretch include your Hamstrings, Gastrocnemius, Soleus and Plantar Fascia. (Read this blog post to get some stretching ideas)

2nd you must reduce the pounding stress:

Pounding stress is caused by too much blunt force trauma. Either you are using your feet too much on surfaces that are too hard…or…you weigh too much. Or sometimes a combination of both factors.

heel strike

The only way to reduce this type of stress is to either lessen the impact of each footstep or take fewer footsteps. Take a close look at how much work you are expecting your feet to do on a daily basis. If you are a heavy person or if you do a lot of high impact activity – you might have to drastically cut back.

3rd eliminate twisting stress.

If you are having heel pain, the chances are good that there is something wrong with the angle at which your heel contacts the ground. Maybe your heels roll out too much (Supination) or roll in too much (Pronation).  These extra motions mean that your heel has to twist as it strikes the ground, this causes excess stress in both the soft tissue and the bone surrounding the heel.

Supinated Pronated

Pronation or Supination could be the root of your problem. The best way to correct your foot alignment is with custom orthotics. Custom orthotics are made by Certified Pedorthists (like me, for example), Orthotists and Podiatrists.  They cost a lot of money, but they are worth it if you can’t kick your heel pain on your own.

foot-orthotic

If all else fails

Surgery is one solution that is sometimes promoted by podiatrists and orthopedic surgeons for the elimination of heel spurs. Well, that’s a pretty drastic measure – and I think that it is best to avoid it if at all possible. You see, surgery tends to lead to scar tissue (which is a lump of hardened, disorganized tissue that forms whenever soft tissue is operated on.) Scar tissue often leads to reduced flexibility and sock absorption in the damaged area. This in turn changes your biomechanics, causing your body to handle the stress of walking in a slightly different way than it usually would. This could cause increased pressure in those areas. Which could lead to…you guessed it, an overuse injury – like a bone spur. This is sometimes an example of the cure being worse than the disease. But just because I am not an advocate for surgery doesn’t mean it is always a bad idea. I’m just telling you to be sure to get a second opinion…and then a third…before you (proverbially) jump in with both feet.

Walk well!

Illustrations from:

http://www.walgreens.com/store/c/medi-dyne-heavy-duty-gel-heel-cup/ID=prod5874552-product

http://www.ortho-net.com/mcdavid/heel_cups-650.htm

http://www.theinsolestore.com/pedag-point-heel-spur-inserts.html

http://www.footsolutions.com/foot-problems

http://runningrules.com/run-like-a-fish-why-or-why-not-someone-might-want-to-change-their-shoes-or-style-of-running/

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