SUBCALCANEAL HEEL PAIN

SUBCALCANEAL HEEL PAIN

Pain in the plantar pad of heel in a common condition and has been reported in patients aged from 18 to 80.

It is a summation of series of micro trauma to the plantar fascia caused by a strain of the attachment of plantar fascia to the calcaneum.

AETIOLOGY:

Excessive Pronation of subtalar joint

Repeated stress over the fascia.

Pes cavus highly arched foot.

Occupational stress like prolonged standing and walking.

High heel shoes.

Obesity

Length and stride during running

Wearing shoes without sufficient

CLINICAL FEATURE:

• Sharp or acute pain over the heel.
• Pain is most severe when the athlete first puts weight on the foot.
• Pain occurs in the heel when no person getting out of the bed in the morning.
• Pain diminishes during activity.
• Pain increase when the activity stops.
• Tenderness over the calcaneal end of the Aponeurosis seen over the anterior medial tuberosity of the calcaneum.

INVESTIGATION

X-Ray

May reveal the presence of calcaneal spur.

MANAGEMENT:

Medical Management

Cortisone injection

Aspirin pills

Soluble steroid injection

Physiotherapy Management

Acute phase

Pulsed ultrasound

Electrical stimulation

Faradic foot bath.

Rehabilitation phase

• Continuous ultrasound
• Ionoto / phonopheresis
• Cryotherapy

Stretching

• T.A. Stretching
• Foot mobilization
• plantar fascia stretch
• intrinsic foot muscle strengthening

Foot Support

• Custom foot Orthosis

Home program

• Avoid prolonged standing
• Advice about suitable standing foot wear.
• Exercise for intrinsic foot muscle should be taught to the patient.
• Contrast bath
• Rest splits should be administered if necessary.

Exercise

• Pricking a golf ball and up your toes.

Lay a towel on the floor and scrunch it up with your toes