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Wednesday, April 25 Sports

The Sports Doctor: Heel pain can derail training

We recently had the opportunity to meet with a former high school star and college athlete who grew up in Fairfield County. He now has heel pain.

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Fact box

The heel bone, known as the calcaneus, is a thick, rectangular bone. At the bottom of the calcaneus is a heel pad to cushion the heel with the ground. There is also a ligament which runs along the arch from the heel to the toes. This is called the plantar fascia; and it elevates, or supports, the arch.

The spur formation is usually a shelf of bone, the entire width of the heel bone. It is formed by the continuous tearing away of the lining of the heel bone by the pull of the strong plantar fascia due to abnormal pronation (inward rotation) of the foot during heel contact, midstance and the toe-off gait.

There are several possible causes of heel spurs. One is poor shoes. Poor shoes may be worn down on the heel area, or may lack rear foot control and/or cushioning. Another cause may be from running or walking on hard surfaces, including concrete roads. However, spurs are primarily due to the abnormal geometrical changes of the foot mechanics, due to excessive foot pronation.

The pain may radiate into the sole of the foot. Actually, the pain is not due to the spur itself, but to the fibrous bursa, or sac, which surrounds the spur. In its early stages, heel spur syndrome has a characteristic pain cycle of greater soreness in the morning or after sitting for any long period of time, and of becoming less painful after walking or jogging.

Therapy for heel spurs includes resting and going to an alternate aerobic activity such as swimming or biking to stay in cardiovascular condition. I am a believer in walking to increase blood flow to the tissues, as our own natural healing elements. The rule of thumb is that if you can walk without pain, then you may start back with your activities in moderation.

Dr. Robert F. Weiss, a Sport Podiatrist, was a member of the Medical Advisory Committee of the 1984 & 1988 Olympic Marathon Trials.