Become a member of the #prostebez Community Running Club https://bit.ly/klubPROSTE_BEZ FREE Running Counseling https://www.prostebez.cz/poradna/ Film from Lednice with Tonda • Prostě Tonda What is a heel #spur? Heel spur is a common and painful problem. It occurs most often in people between 30-60 years old, earlier in runners, and is manifested by pain in the heel and the entire sole of the foot - paradoxically, especially at rest, typically in the morning after waking up, while walking the pain subsides. The cause is chronic strain and damage to the plantar fascia - in Czech, foot ligaments. This fibrous membrane is stretched between the front part of the heel bone and all five breasts, to which it radiates. The plantar fascia forms the longitudinal arch of the foot and absorbs a large load when standing, walking and running, both by passive stretching and by shock absorption. Chronic overload leads to the development of aseptic inflammation (i.e. inflammation without viruses or bacteria), minor trauma to the fascia, and pain. The place where the fascia attaches to the heel bone calcifies – it calcifies and turns into bone. A heel spur is formed. The spur itself visible on an X-ray may not correspond to the length and severity of the problem – what is troubling us is damage to the fascia – plantar fasciitis. Today, the term fasciosis or fasciopathy is also used. Similarly, inflammation and a spur can develop on the back of the heel at the point of attachment of the Achilles tendon, but that is another chapter. Causes The causes of the condition are not fully understood, and it is assumed that there is an interaction of many unfavorable factors. Chronic stress from prolonged standing, excessive pronation, obesity, reduced ankle mobility in the direction of dorsal flexion (“whistle”), shortening of the Achilles tendon. Shoes with a narrow toe, hard insole and inflexible sole are not suitable. For runners, risk factors include overtraining, sudden increase in training volume, unsuitable running shoes, running on hard surfaces, excessively arched foot arches. Prevention and possible treatment It is important to choose suitable soft shoes, or even orthopedic insoles with heel relief. When it comes to running shoes, do not forget about their wear and tear and change them after 800 kilometers at the latest. Comprehensive physiotherapy helps, which includes active exercise, stretching the calf muscles and plantar fascia. Massage the foot gently, preferably three times a day. Sometimes walking barefoot on fine pebbles is also promoted, while others do not recommend walking barefoot. In acute problems, anti-inflammatory drugs are used locally and generally, the use of corticosteroids is questionable. Local X-ray irradiation is a widely used method, but today it is often questioned. The best results are now described with so-called shock wave treatment - it is provided by several workplaces in our country, it is a non-invasive, non-surgical method, recovery is fast and the success rate is high.