All about heel spurs and the role of physical therapy

Heel thorn or plantar fasciitis pain (in English: Plantar fasciitis) is one of the most common foot disorders in adults, which occurs especially in people who are very active, stand for a long time or are overweight. This condition occurs when the thick fibrous band called the plantar fascia, which runs from the heel bone to the toes, becomes chronically inflamed or stretched. Sometimes a small bony appendage (heel spur) is also created at the junction of this strip.

One of the symptoms of this problem is the feeling of severe pain when taking the first step in the morning or after sitting for a long time. Even standing or walking for a short time can aggravate the pain and disrupt the quality of life. This pain not only limits daily activities such as walking or standing, but sometimes leads to a change in the way of walking and incorrect use of the body.

However, there is a lot of hope; Because a combination of conservative treatments and specialized physiotherapy can improve many patients without the need for surgery. Physiotherapy not only relieves pain, but also improves foot function and reduces the risk of recurrence with targeted exercises, biomechanics correction, and manual therapy techniques.

In this article, we intend to examine this problem comprehensively: from the precise definition and underlying causes to modern and practical treatment methods. Next, you'll learn the critical role of specialized physical therapy—proper stretching exercises, strengthening plantar muscles, gait correction, and proper shoe and insole use. Also, safety tips and side care that prevent the return of pain will be reviewed.

Causes and risk factors of heel spurs

A heel spur is a bony appendage that is caused by repeated stretching and chronic inflammation in the fibrous band of the plantar fascia. But what factors play the biggest role in the formation of this problem? In the following, we examine the most common risk factors and underlying reasons:

• Weight gain or sudden change in weight, the greater the body weight, the more pressure on the foot, especially the heel area. Sudden weight gain (such as during pregnancy or after quitting an exercise program) can overstretch the plantar fascia. Even a few kilograms of extra weight can turn the time of taking the first step in the morning into a souvenir of pain.
• Improper shoes and lack of arch support, shoes with very thin heels, or without proper cushioning, cause direct transfer of pressure to the soles of the feet and fascia grafts. Also, very heavy shoes or not having a proper support arch can cause heel spurs over time. Jobs with long standing need proper medical shoes.
High-stress sports activities People who regularly run on hard surfaces, jump, or do sports such as basketball, volleyball, and interval running are more at risk of developing heel spurs than others. Repetition of direct impact on the soles of the feet causes chronic inflammation and gradual damage to the fascia.
• Biomechanics and incorrect structure of pasans who have flat feet or high arches are exposed to uneven pressure on the plantar fascia. These structural problems can cause stretching and eventually chronic inflammation in the heel area.
• Increase in age and sex, with age, soft tissues such as the plantar fascia lose their elasticity. Therefore, people over 40 are more prone to inflammation and heel pain. Studies also show that the chance of getting it in women is slightly higher than in men, which is related to the differences in biomechanics and body structure.
• Standing or walking for a long time in the workplace, such as teachers, salesmen, production line workers and nurses, who spend many hours standing, are more prone to heel pain. Continuous standing, especially on hard surfaces, puts a lot of pressure on the fascia and aggravates the inflammatory process.
• Frequent injury or pressure on the sole of the foot, such as running without warming up, wearing inappropriate shoes, or a sudden increase in activity, may cause severe inflammation. Even the use of heavy bags that do not have a proper weight distribution, put pressure on the body, which indirectly affects the heel.

By knowing these factors and timely prevention (using the right shoes, controlling weight, correcting the walking posture and doing proper exercises), the possibility of getting heel spurs can be significantly reduced.

In the next sections, we will review diagnostic methods, treatment and the role of physiotherapy.

Symptoms of heel spurs: from morning pain to movement restriction

Heel spurs usually appear slowly and gradually, but the pain can become so severe that it makes it impossible for a person to walk. Knowing the common symptoms of this condition helps in timely diagnosis and treatment. In the following, we examine the most important signs of heel spurs:

• Heel pain on the first step in the morning is one of the most classic symptoms of heel spurs. After waking up, when taking the first step, the person feels a sharp and burning pain in the heel. After walking a few steps, the pain subsides but returns at the end of the day or after sitting for a long time.
• Pain after long standing or heavy activity If you have to stand for hours, especially on a hard surface, you are more likely to experience pain. This pain is usually felt as pressure or shooting in the center or inner edge of the heel.
Burning sensation or inflammation in the soles of the feet Some people feel that the soles of their feet are inflamed or even hot, as if the foot is "burning". This issue usually occurs due to frequent inflammation of the plantar fascia.
• Limited movement and changes in walking style As heel spurs progress, a person may unconsciously shift their weight forward or to the outer edge of the foot to take pressure off the heel. This problem eventually causes knee, hip or back pain.
• Persistent or chronic pain In more advanced stages, a person may experience heel pain even while resting or sitting. In this situation, the created bone spur causes continuous irritation of the surrounding soft tissues and causes chronic pain.
• One-sided or bilateral pain, although in most cases, heel spurs occur only in one foot, but in some patients - especially with biomechanical disorders - both feet are affected.

⚠ Note: Many symptoms of heel spurs are confused with other problems such as Achilles tendonitis or stress fractures. Therefore, accurate diagnosis by a doctor or physiotherapist is necessary.

Diagnosis of heel spurs: when to see a doctor or physiotherapist?

If detected in the early stages, heel spurs can be treated with non-surgical and minimally invasive methods. But many people ignore the pain of the sole of the foot and go to the doctor when the problem becomes chronic or the range of motion of the foot is severely limited. Early diagnosis is the key to successful heel spur treatment. If you experience any of the following symptoms, it is better to see a doctor or physiotherapist as soon as possible for an accurate diagnosis:

• Sharp and shooting pain in the heel when waking up
• persistent pain even at rest
Difficulty walking, running, or climbing stairs
• Inflammation or abnormal heat in the heel
• creating an appendage or bony protrusion in the heel area

🔹 history and physical examination

In the first step, the physiotherapist or doctor will talk to you about the history of pain, the amount of activity, the type of shoes and when the symptoms started. Then, by touching the sensitive points of the soles of the feet, testing the flexibility of the leg muscles and checking how to stand and walk, he performs a detailed examination of the function of the soles of the feet.

🔹 supplementary diagnostic tests

In cases where there is a need for visual confirmation or the symptoms are more severe, these methods are used:

• X-ray photography (X-ray): This method shows the presence of bony appendages in the heel with high resolution. Although not all heel pain is caused by a spur, seeing a bony appendage is a good confirmation of the diagnosis.
• MRI or ultrasound: in cases of soft tissue inflammation or fascia tear, MRI and ultrasound help diagnose.

🔹 The role of physiotherapist in diagnosis

A foot specialist physiotherapist can identify the type of pressure placed on the sole of the foot and suggest corrective exercises by using functional evaluations, examining the walking pattern and biomechanical analysis of the body. Unlike only symptomatic treatment, physical therapy also examines and corrects the underlying cause.

If detected in the early stages, heel spurs can be treated with non-surgical and minimally invasive methods. But many people ignore the pain of the sole of the foot and go to the doctor when the problem becomes chronic or the range of motion of the foot is severely limited. Early diagnosis is the key to successful heel spur treatment.

Effective physiotherapy exercises for heel spurs

Physiotherapy exercises are one of the most important treatment methods for heel spurs. These exercises are designed to reduce inflammation, stretch the plantar fascia and strengthen the surrounding muscles. Their correct and regular implementation can significantly reduce pain in many cases and prevent recurrence.

1. Stretching the plantar fascia

• How to do it: sit down and put one leg on the knee of the other leg. With your hands, pull your toes up to feel the stretch in the soles of your feet.
• Duration: 15 to 30 seconds - 3 to 5 times a day
• Benefit: this direct movement affects the plantar fascia and reduces its stiffness.

2. Stretching the calf muscle

• How to do it: Stand facing the wall. Put one leg forward, bend the front knee and keep the back straight. Lean your hands on the wall.
• Duration: 30 seconds for each leg - 3 times a day
• Benefit: reducing pressure on the plantar fascia and facilitating pain-free walking.

3. Rolling a ball or bottle of cold water under the foot

• How to do it: sit on a chair and place a tennis ball or a cold water bottle under the soles of your feet and slowly move it back and forth.
• Duration: 5 to 10 minutes per session
• Benefit: This exercise causes a gentle massage of the soles of the feet and reduces inflammation.

4. Gathering the towel with the toes

• How to do it: Spread a thin towel on the floor. Gather it with your toes and lift it up.
• Repetition: 2 sets of 10 per day
• Benefit: strengthening the small muscles of the sole of the foot and improving the support of the arch of the foot.

5. Stretching with Traband tape

• Method: put a rubber band around the soles of your feet and pull both ends of it with your hands. Now pull the toe towards you and release it again.
• Repetition: 10 repetitions in 2 sets, daily
• Benefit: gradual strengthening of muscles without pressure on the heel.

❗ Important points:

• Exercises should be done without severe pain. It is normal to feel a stretch, but if you have sharp pain, stop the exercise.
• Continuing to do daily exercises is the key to the success of the treatment.
• If an exercise is uncomfortable for you, consult your physiotherapist to suggest an alternative program.

Prevention of heel spurs: how to prevent pain from returning?

Heel thorn is one of the common problems that, although it can be treated, but if the underlying factors are ignored, it can return again. The good news is that by following a few simple principles in lifestyle and foot care, it can be effectively prevented from recurring.

• Choosing the right shoes, not just any shoes! One of the most important principles of prevention is the use of medical and standard shoes. A shoe that:

• Having a soft sole and a supportive arch
  • Having a 2 to 4 cm high heel
  • Providing enough space for the toes
  • Flat shoes, with high heels or without shock absorbers, put pressure on the fascia of the soles of the feet and provide the basis for the return of pain.
• Avoid standing or walking for long periods of time.Standing too much, especially on hard surfaces, is one of the main causes of heel spurs. If your job requires standing for a long time, be sure to use orthopedic insoles and take breaks and stretches at certain intervals.
• Caring for extra weight puts a lot of pressure on the soles of the feet and increases the risk of developing or recurring heel spurs. Losing weight through healthy eating and light exercise can have a direct effect on reducing heel pain.
• Don't forget the daily stretching exercises Even after complete recovery, it is a necessity to maintain the flexibility of the calf muscles and the soles of the feet with daily exercises. Movements such as stretching the fascia, stretching the muscles behind the leg and rolling the ball under the foot can prepare the muscles and keep the pain away.
• Avoid strenuous walking on hard surfaces Running or walking for long periods on asphalt, stone or ceramic without proper footwear can reactivate symptoms. Always use shock-absorbing shoes or change the exercise surface to grass, dirt, or a treadmill.

Prevention is always easier than cure. Heel spurs are uncomfortable, but with a little care and changing habits, you can get rid of them forever.

Frequently asked questions about heel spurs and physiotherapy

What exactly is a heel spur and why does it occur?

A heel spur is a small bony growth under the heel bone, usually caused by long-term inflammation in the tissue of the sole of the foot (plantar fascia). Frequent pressure, standing too much, inappropriate shoes or overweight are the main factors.

Are heel spurs dangerous?

No, heel spurs are usually not dangerous, but if left untreated, they can become chronic and debilitating. Chronic pain causes difficulty in walking, fatigue and even knee or back pain.

Is it treated without surgery?

Yes! More than 90% of cases improve with non-surgical treatments such as physical therapy, specialized exercises, medical shoes, and lifestyle modifications. Surgery is recommended only in very rare and resistant cases.

How does physical therapy help heal heel spurs?

Physiotherapy using techniques such as stretching and strengthening exercises, manual therapy (manual therapy), laser, ultrasound, or TENS reduces inflammation, improves blood circulation, tissue regeneration, and eliminates pain. Also, the physiotherapist helps to correct the way the patient walks or stands.

Is it possible to exercise with heel spurs?

Yes, but not every sport. Jumping exercises, heavy running or activities on hard surfaces should be avoided. Instead, low-stress sports such as swimming, water exercises, leg stretching and specialized yoga are recommended.

How long does it take for a heel spur to heal?

Depending on the severity of the disease, between 4 and 12 weeks are needed to control the symptoms with conservative treatments. Continuity in exercises and following care tips play a big role in the speed of recovery.

Is it possible for the disease to return after treatment?

Yes, heel spurs can return if underlying factors such as improper footwear, excess weight, or prolonged standing are not corrected. But by observing preventive care, the probability of return will be very low.

Conclusion: say goodbye to heel spurs with the help of physiotherapy

Heel spurs are one of the most common causes of pain in the heel area, which can disrupt daily activities and reduce quality of life. Fortunately, it can be effectively controlled and treated with timely diagnosis and non-invasive treatment methods such as physiotherapy. Physiotherapy plays a key role in reducing inflammation, improving muscle function and relieving pressure from damaged tissues. Specialized exercises, manual therapy techniques, and modern physiotherapy tools such as laser and ultrasound help the person to return to normal activities without surgery.

If you also suffer from heel pain, it is better not to ignore this problem. Consultation with an experienced physiotherapist can be the start of a path to walking again, without pain.

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