Friday, June 23, 2023

Heel Spur Syndrome & Foot Ligaments

Heel Spur Syndrome & Foot Ligaments

WHAT IS HEEL SPUR SYNDROME?

Plantar fasciitis, or also know as heel spur syndrome, is an inflammation of the ligament which connects your heel bone to your toes. This ligament is called the plantar fascia. Classic symptoms of plantar fasciitis include pain in the area of the heel near the inside of the foot where the arch of the foot begins. Most individuals feel pain in the morning or after a long period of rest. This is called post-static pain. When you are at rest or not bearing weight on the foot, this time allows the ligament to contract. Therefore when one plants the foot down the ligament will stretch and cause pain. Current thoughts on are that the heel spur that is sometimes associated with plantar fasciitis is not another source of the pain. The spur is simply an extension of bone after the plantar fascia continually stretching and pulling on its insertion on the heel bone.


HOW IS HEEL SPUR SYNDROME DIAGNOSED?

Plantar fasciitis can be diagnosed by your doctor through a thorough history and physical exam. Ancillary testing, like X-rays, MRI, bone scan, or a CT*, can be performed additionally to exclude or include any other boney or soft tissue abnormalities.

[* Note: CT scan: A computerized tomography (CT) scan combines a series of X-ray images taken from different angles and uses computer processing to create cross-sectional images, or slices, of the bones, blood vessels and soft tissues inside your body. CT scan images provide more detailed information than plain X-rays do.]

 Ultrasound can be used to confirm the diagnosis. Thickening is noted on the ultrasound due to the inflammation and swelling of the ligament. Additionally, blood tests can be performed to diagnose any arthritic or infectious disorders that can be the cause of the heel pain.


WHY DO I HAVE HEEL SPUR SYNDROME?

Plantar fasciitis heel pain syndrome can occur via a myriad of causes. Risk factors such as weight gain, foot type (flat feet, high arched feet), a high level of activity, sports, overuse, improper shoegear, improper support of the feet, trauma, tightness of muscles and daily activities can trigger the classic symptoms. Often, there is no single cause, but a culmination of several risk factors. It is imperative to address all of these factors to treat this condition successfully.


HOW CAN I TREAT THIS PROBLEM?

Evaluating your shoes and switching to a more supportive comfortable shoe is an important step. If the pain continues, decrease your current activity level and start taking anti-inflammatory medication like advil or alleve.



Our office is proud to now offer a groundbreaking laser treatment for heel pain that is clinically proven to be effective. For more information about our Laser Therapy, click here.


WHAT WILL MY DOCTOR DO FOR THIS PROBLEM?

We will evaluate the symptoms and history that you present to us, take an in office X-ray to rule out other possible diagnoses like arthritis, foreign objects, fractures, etc., and we will review our findings and the treatment options that would best suit the severity of the condition.


Treatment options include prescription strength oral nonsteriodal anti-inflammatory medication, laser treatment, physical therapy, stretching exercises, icing, strapping of the foot, custom orthotics (inserts), injections, weight loss programs, evaluation of your shoe gear, night splints, casting, and ultimately surgery.


Conservative treatment is usually very successful and surgery is rarely required. We try to avoid surgery for this problem due to the fact of the anatomical importance of this ligament in the way your foot functions. Altering this ligament has can affect the natural function of the foot.


For those who ultimately need the surgery, we offer minimally invasive endoscopic surgery to release part of the ligament and also ESWT (extra corporeal shock wave therapy) which utilizes sound waves to help alleviate the pain associated with plantar fasciitis. Both methods are FDA approved methods to treat plantar fasciitis and have minimal down time. The decision on which treatment is suited best for an individual patient is made by your doctor based on the details and severity of symptoms.


CAN I PREVENT THIS FROM HAPPENING AGAIN?

Maintaining supportive shoes and also having additional support in your shoes can help prevent this from reoccurring. Weight control will keep added pressure from being exerted on your feet. Continuing stretching exercises will help keep the ligament loose. It is very important to listen to your body and attend to any pain that arises immediately. Chronic pain is harder to treat than acute pain.


Difference Between Ligaments and Tendons?

Foot Ligaments 

Your feet are complex and hard-working body parts. They contain 26 bones, 30 joints and over 100 muscles, tendons and ligaments. Your foot includes three main ligaments that connect your bones and provide support for the  of the foot.

Ligaments and tendons are both made up of fibrous connective tissue, but that’s about where the similarity ends.

Ligaments appear as crisscross bands that attach bone to bone and help stabilize joints. For example, the anterior cruciate ligament (ACL) attaches the thighbone to the shinbone, stabilizing the knee joint.


Tendons, located at each end of a muscle, attach muscle to bone. Tendons are found throughout the body, from the head and neck all the way down to the feet. The Achilles tendon is the largest tendon in the body. It attaches the calf muscle to the heel bone. The rotator cuff tendons help your shoulder rotate forward and backward.

Read on to learn more about ligaments and tendons.

Foot ligaments are strong bands of tissue that connect various bones in your foot. The ligaments in your foot help stabilize it. They also provide necessary support to the arches in your feet.

Because there are so many bones in the foot, there are also numerous ligaments connecting them. Some of the main ligaments in the foot are:

•Plantar fascia ligament: Runs underneath your foot from the heel to the base of your toes.

•Plantar calcaneonavicular ligament (spring ligament): A strong ligament that connects bones in the ankle and foot, gives your arch structure and helps support your body weight.

•Calcaneocuboid ligament: Connects your heel bone to your tarsal bones that make up your foot’s arch.

•Lisfranc ligaments: Located beneath the Lisfranc joint in the midfoot.


Ligaments are bands of fibers interconnected in strong, cord-like ropes. In your feet, ligaments attach bones to each other. You have ligaments all over your body that hold bones together. Some ligaments also support internal organs. 

The primary purpose of the foot ligaments is to stabilize and support the arch. The arch is formed by bones, ligaments and tendons. The arch gives shape and structure to your foot.

Foot ligaments help support your body’s weight. They also absorb the impact your body feels with every step. 

Where are the foot ligaments located?

Foot ligaments run throughout your foot. Ligaments connect all 26 bones in each foot. Different foot ligaments:

•Run from your toes to your heel, supporting your arch.

•Crisscross to connect the tarsal bones in your arch. 

•Connect the metatarsals (the long bones that lead to your toes). 





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