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.
