Physical Therapy for Heel Spurs
Save the Heel Spurs for Cowboys!
Get Help for Painful Heel Spurs!
If you have been dealing with pain, inflammation or warmth over your heel, you could have a condition called a heel spur. This condition affects up to 1 in 10 adults though many individuals may not even realize they have a heel spur.. The likelihood of finding them on imaging increases with age. For those experiencing discomfort due to the presence of a heel spur, let’s learn more about the condition and how PT can help.
TWO TYPES OF HEEL SPURS
Heel spurs are a type of bone spur named for their location along the calcaneus or heel bone.
They can develop in two different locations along the calcaneal bone. When a bone spur forms along the bottom of the heel on the sole of the foot, it is called bone spur syndrome. Alternatively, a bone spur that forms on the back of the calcaneus where the achilles tendon inserts is called insertional achilles tendonitis. In some cases a bony protuberance can be felt under the skin in these areas.
The medical term for bone spur is osteophyte. The prefix “osteo” means related to bones while the suffix “phyte” refers to pathologic outgrowth. Taken together, the term osteophyte refers to an outgrowth of bone. The body most commonly develops bone spurs in an attempt to repair or address an injury. It does so by producing excess bone and calcium where there has been trauma to the joint, repeated tendonitis, breakdown of the cartilage or repeated overuse of a joint. Does anyone else in your family have bone spurs? Research suggests it may also have a genetic cause
Bone spurs are most common in adults over the age of sixty and usually grow in areas where osteoarthritis–breakdown of the cartilage from wear and tear–has formed in a joint. Bone spurs can grow from any bone but are most common in the foot (especially the heel, big toe and ankle), the hands and fingers, hips, neck and spine, knees and shoulders. In the heel, repeated stretching of the plantar fascia or tearing of the membrane that covers the heel bone can lead to heel spur formation. Runners that run on hard surfaces, those wearing improper or unsupportive footwear when on their feet for long periods and those who are overweight or obese are also at a higher risk for developing heel spurs.
NOT ALL HEEL SPURS CAUSE SYMPTOMS
Oftentimes the presence of a heel spur is an incidental finding when looking for something else. It is important to rule out other causes for foot or heel pain as the presence of a heel spur is not necessarily associated with having symptoms. In the case of heel spur syndrome it is important to differentiate between a case of plantar fasciitis and a symptomatic heel spur. So while some heel spurs are asymptomatic, bone spurs located in an area that can irritate tissue or impede range of motion can cause symptoms. If you are experiencing any of the following symptoms, you may have a heel spur:
Sharp pain or intense ache in the heel that is often worse first thing in the morning or after a longer period of rest
Inflammation or swelling over the heel
Tenderness when touching or applying pressure to the area
Warmth over the area
A palpable bony protrusion in the heel
CONSERVATIVE MANAGEMENT CAN HELP MANAGE HEEL SPURS
Conservative, non-surgical management like physical therapy results in symptom improvement in the majority of patients. By making some of these changes you can help improve the long-term success of your rehabilitation program:
Avoid long periods of time on your feet. Take breaks regularly, especially in the beginning of your treatment when you are more symptomatic
Wear well-fitting shoes with proper arch support when you will be standing or walking for extended periods
Wear slippers or cushioned shoes for walking on tile or hardwood floors at home
Run or walk on softer surfaces outdoors like grass rather than only on hard surfaces like concrete or asphalt.
Heel pads or shoe inserts may be beneficial to help distribute pressure more evenly across the heel
Physical therapy can be a great tool for managing symptomatic heel spurs. While it is true that physical therapy will not eliminate the heel spur, it can help reduce the irritation and inflammation around the spur that is causing your symptoms. As mentioned earlier, many people have heel spurs without any symptoms and we’d like you to be one of those people. Physical therapy aims to reduce inflammation, improve foot and ankle motion, address muscle and soft tissue impairments and improve the quality of movement to minimize heel spur symptoms.
Let's take a look at some exercises that can help manage the symptoms of a heel spur that your PT may prescribe. Please note, it is important to check with your doctor before starting a new exercise plan. Also, these exercises are meant to be only examples of what you may encounter while working with your physical therapist. Your PT will provide you with a customized physical therapy exercise program to treat your heel pain.
Calf stretching: Stand with your hands against the wall in a lunge position. With the back foot pointed straight ahead and knee straight, lunge forward over the front foot until you feel a moderate stretch in the back calf muscle. Hold for 20-30s and perform 2-3 repetitions to help stretch the calf muscle.
Big toe stretch: While seated, grasp your big toe on the symptomatic side and gently pull it back toward you until a gentle stretch is felt along the bottom of your foot. Hold this for 20-30s and perform 2-3 repetitions at a time to help mobilize the big toe and stretch the plantar fascia.
Massage: If your heel spur is on the sole of the heel, massaging the plantar fascia and bottom of the foot may help. Place a massage ball or frozen water bottle under your foot and roll your foot back and forth across the ball or bottle spending extra time in spots that feel tender.
Arch strengthening: Start by sitting with your feet flat on the floor. Place a pen under the arch of your affected foot. Without raising the foot off the ground, use your intrinsic foot muscles to try and lift the arch up and off the pen, holding for a few seconds at the top before lowering back down. Perform 15-20 reps for 1-2 sets to help re-educate and strengthen the muscles that support the arch. Progress to standing when you are ready for a greater challenge.
While in some cases surgery may be necessary to remove heel spurs, a physical therapist at Evolve can help you to reduce pain and swelling, improve your joint mobility and optimize your movement patterns. Give us a call today to schedule an evaluation and learn more about how we can help you manage the symptoms of a heel spur. Call: 1-718-258-3300
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