Finally heel pain explained!

Well, I finally went to a Podiatrist/Sports Medicine Dr. I explained the pain I started getting in my heel when I started spinning and riding about a month ago. We pushed on my heel and I almost went through the roof. Well, an x-ray later....sure enough he walked in and said you have a HUGE heel spur and showed me the xray :( He gave me stretching exercises to do, told me to ice it and take motrin for the next 5 days. If it doesn't calm down I'm going to have to have surgery!:eek: Well, I've kept riding it still hurts but not as bad. I did 24 miles yesterday and it hurt a little. Now, my left heel is starting to hurt! Oh, well, he thinks it was from all my years of running and the spinning and cycling have just irritated it.
Anyone else ever had a heel spur and if so please tell me there is an alternative to surgery!
Thanks
Jenn

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Originally Posted by Jenn

Well, I finally went to a Podiatrist/Sports Medicine Dr. I explained the pain I started getting in my heel when I started spinning and riding about a month ago. We pushed on my heel and I almost went through the roof. Well, an x-ray later....sure enough he walked in and said you have a HUGE heel spur and showed me the xray :( He gave me stretching exercises to do, told me to ice it and take motrin for the next 5 days. If it doesn't calm down I'm going to have to have surgery!:eek: Well, I've kept riding it still hurts but not as bad. I did 24 miles yesterday and it hurt a little. Now, my left heel is starting to hurt! Oh, well, he thinks it was from all my years of running and the spinning and cycling have just irritated it.
Anyone else ever had a heel spur and if so please tell me there is an alternative to surgery!
Thanks
Jenn

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Wow that really sucks. I hope you are quickly pain free and find a surgery alternative!

What exactly is a heel spur?

Jenn, it's a simple surgery.
Imagine the freedom from that pain!

m

My understanding is that a heel spur is a reaction to stress on the plantar fascia. Perhaps a tear occurred there, and the body is building it up. It's been several years since mine flared up and I read up on it. I remember one particular site that was very helpful, and wasn't trying to sell anything. Can't find it now.

I found this: http://www.healthscout.com/ency/68/224/main.html
"The heel bone forms one end of the two longitudinal arches of the foot. These arches are held together by ligaments and are activated by the muscles of the foot (some of which are attached beneath the arches and run from the front to the back of the foot). These muscles and ligaments, like the other supporting tissues of the body, are attached in two places. Many are attached at the heel bone. The body reacts to the stress at the heel bone by calcifying the soft tissue attachments and creating a spur."

What really helped me the most was making sure not to sleep with my toes pointed under the covers. That, and not having a job where I stood on expanded metal grating all the time in steel-toed boots.

You could have the surgery, but they can get better without it. It depends on how much time you want to devote to healing. Mine is still there, it just doesn't hurt. I pay attention to my foot wear. But I also don't run, as a rule. I don't know how a runner would get over it, if they wanted to keep running.

Karen

I have been seeing a podiatrist for heel spurs for over a year now. Heel spurs are a hook of bone at the back of the foot. From what I understand, it is not the heel spur which causes the pain, but rather the inflammation and irritation of the plantar fascia. I understand the surgery, while simple, leaves you basically unable to use that foot for 3 weeks and then very little for another 3 weeks. It is critical that the foot not be used at all because the tendon (which is severed) needs to reconnect.

I was treated with cortizone shots and orthodics. It seems cycling and spinning (which replace running/walking) has alliviated 90% of my pain.

A useful article: http://www.aapsm.org/plantar_fasciitis.html

I'm afraid this post is really long, but I want to give you advice that's gotten me to the point where today I can run 3.1 miles without any heel pain before, during or after exercise -- or even in the mornings. I struggled with heel pain for a long time and had given up walking completely because I thought there was no hope.

Somewhere in 2005, I started getting bad heel pain. I had started walking for exercise, and saw a podiatrist who said there was nothing I could do but to stay off of it while it healed. Said the only alternative was surgery, which might not work anyway. He taped it and sent me on my way. (I'm quite overweight, BTW. My weight was about what it is now because I gained weight after that and into 2006.)

In August 2006, I started a beginner walking/running program. I got top of the line shoes from a running store -- the Brooks Ariel -- that is designed for heavy people who overpronate. I was only walking in this program. I had heel pain no matter how much stretching I tried, and I got shin splints so bad that I was walking somewhere around 2.0 mph. I bought $30 PowerSteps insoles. Did nothing to relieve the pain.

I asked the program director for the recommendation of another podiatrist, and saw him. He took a quick peek at my X-ray, and said that I have a mechanical problem that is causing my heel spurs (I have one at the back at the achilles AND one on the bottom of my heel).

He also said I don't overpronate much and was wearing too much shoe. He gave me over the counter $20 orthotics. I also started physical therapy because my calves are tight. (Couch potatoes measure at 10, and I measured at a -1.)

I went back to the running store, demanded to have the owner fit me and got completely different shoes.

Within minutes of wearing the $20 orthotics, I felt the pain greatly reduced and within a week my shin splints and heel pain were COMPLETELY GONE.

The physical therapy was tough. Ideally, you need to stretch 3-4 times a day. I use this handy device. I *really* *really* *really* like it because it gets me a deeper stretch without the pain of pulling on my foot with a strap or towel. I was in physical therapy, twice a week, for a month. The physical therapist also had me ice the plantar fasciia after each session, and I did this at home, too.

I have a foot rest at my desk at work, and I can use that to stretch also.

I was also given an anti-inflammatory, but I wasn't good about regularly taking it. :o

I tried using the night sock, but could never get through the night with it on. In my opinion, this did little to help me heal.

I now have custom orthotics, which were covered by my insurance, but the other ones would have worked fine, too. I will warn you, though. It took me a good 2 months of daily wear to get to the point where I like the orthotics. Now I don't even notice them but can tell right away if I try to go without.

I also have custom orthotics that fit in my cycling shoes, but I did have to pay the full cost of those because they were not covered by my insurance. PowerSteps makes insoles designed for cycling shoes. And if you're using a clipless pedal like SpeedPlays, that may not be a wide enough platform to keep your foot stable. A co-worker tore her plantar fasciia, and she said having a bike fitting by a physical therapist (run through a medical center here) really helped her after she was out of the cast.

I am completely pain free, but if I neglect my stretching I do feel it, so once you feel better, you will need to continue stretch regularly.

So, to sum up a reeeeeaaaaaaalllllyyy long post:

1. Get a second opinion before having surgery.

2. Get custom orthotics! This has helped me more than I ever thought possible, even though I didn't like going from the $20 pair to the custom pair at first.

3. Have the owner or manager of a running store look at you and fit you with shoes. If you can at work, wear comfortable shoes. I wear Merrels with my orthotics, and then have dressier shoes if I have to go to a meeting.

4. Stretch, stretch, stretch. Every time you go to the bathroom, stretch. Stretch before getting up after you sit for a while. Stretch the calves ALWAYS after you warmup and ALWAYS when you're cooling down. Don't skip stretching even though it's boring.

5. Ice.

6. Try taping.

7. Don't push it. Rest and then take things gradually.

I cannot thank all enough for the GREAT advice!! I'm glad I'm not the only person in with this....Gosh, it hurts sooo bad at times and then not so bad. I work at home, chasing a 1 year old all day so stretching isn't a problem I just have to remember to do it. I did my spinning this morning and tried to pay more attention to how I'm moving my foot, don't know if that makes much of a difference.
Thank you for giving me some hope!!:D
It was just a horrible thing, after being a nurse and seeing the xray and knowing what my normal heel is suppose to look like, then seeing this HUGE spike looking hook calcification coming under the bottom.......:eek: no wonder it hurts so much.
Thank you all again!!
Jenn

We used to do iontophoresis with acetic acid to heel spurs to help soften them up and resorb them. Depending on the size and thickness of your spur, it may or may not be worth a try.

Knot, what is that?
My son Tom has a heel spur from an old injury (either Karate or climbing)
so i don't think it's postural but it sure could be..

It has been suggested to him that he have surgery but he keeps putting it off.

soak an iontophoresis pad (like a big gooey bandaid) with acetic acid (the stuff in vinegar) slap if on the heel, and run an electric current thru the pad and then out a grounding pad with no acetic acid.

The current drives the acetic acid thru the skin and into the area around the heel spur, where the acidity helps to disolve the spur.

It doesn't get rid of the spur, and it doesn't stop whatever structural or functional issues are causing the spur, but I've seen it decrease the severity of spurs enough that with PT and shoe adjustments the patients could avoid surgery.

It doesn't work for everyone, but it does work for some.

I had something done with ultrasound in physical therapy. Waved a wand over my foot. It felt really good, but that could have just been the massage. :D

+1 what OTG and Knot said.

You really don't want to have surgery if at all possible and conservative management can often resolve the pain if not the spur.

One thing to remember is that your body put that spur there for a reason. There is too much tension on the plantar fascia and it's pulling on the bone. The bone responds by laying down more bone to try to heal it, much like it would in the case of a fracture. You need to resolve the stress on the fascia to solve the problem. That's where PT, orthotics and stretching come in. If you go in and take out the spur without solving the biomechanical issues, you can continue to have problems, not to mention the risk of surgery.:eek: :eek:

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Originally Posted by Offthegrid

The physical therapy was tough. Ideally, you need to stretch 3-4 times a day. I use this handy device. I *really* *really* *really* like it because it gets me a deeper stretch without the pain of pulling on my foot with a strap or towel.

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I found that I got the same effect that this device provides by standing on the edge of a step on my toes and stretching my heels downward toward the next lowest step. I haven't had a problem in years since I've been doing this...

But now I feel deprived: :eek: I'm a gadget junkie and I've been using a gadgetless solution not knowing that there was a gadget solution out there:eek:

Unfortunately, I have an unusually high arch, which he said is really adding to my problem. He did NOT like my biking shoes I just bought, he did NOT like my running shoes, Oh me, am I doomed to wear the dreaded Birkenstocks?:eek: (sp)
I have been doing ALOT of stretching and icing it everynight. I stretch it like I believe Mr Silver said by putting the ball of my foot on the end of my treadmill and pushing down, I can really feel that. I'm taking iburofin and I a can of frozen O.J. at night rolling it back and forth is helping.
Thank you all for the anti surgery advice, I left his office in tears. I saw a procedure done for a spur when I was 20 something, and that was the first time I ever fainted as a nurse, course the patient was awake.
Anywho, thanks again for the great posts. I'm suppose to go back and see him after our trip to Mexico, wish I could take my bike!!

Jenn

My physical therapist told me about a year ago to NEVER let anyone operate on my feet unless all other alternatives had been exhausted, and then, still, not to do it! He hasn't known one successful surgery case in his 20 years as a physical therapist. Don't know any more than that. I could guesstimate why he said that and make assumptions until I am dead, but I think that it would be worth looking into success rates of foot surgeries.
I think that sometimes we aren't gracious enough with ourselves and don't give our bodies time to heal. Patience. Take up something that isn't so hard on your feet, like swimming.
It took a year for the tendons in my feet to heal. I still have to be careful. I kept exercising them, hiking, biking, etc, thinking that the advice was to push through the pain and that healing would come faster. Wrong. All I did was to make healing last 6 months beyond what it should have. I also created scarring inside the foot that had to be dug out by the physical therapist, but, nevertheless, I am rambling now:D ...............
Hope my 2 cents worth helps.......... soak your feet and watch some good flicks!

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Originally Posted by Jenn

Unfortunately, I have an unusually high arch, which he said is really adding to my problem. He did NOT like my biking shoes I just bought, he did NOT like my running shoes, Oh me, am I doomed to wear the dreaded Birkenstocks?:eek: (sp)

Jenn

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Jenn - an unusually high arch also typically means a relatively stiff arch. This allows for less shock absorption. This in turn can lead to the spur. Your focus should be on stretching (I know you already said you're doing this but I felt I needed to say it again because it's *that* improtant) and getting shoes with very good cushioning. This is especially true of walking and running shoes. Cycling shoes aren't designed to reduce shock. You may want to try to put a gel insert in them and try to increase your cadence. Faster cadence = decreased force per pedal stroke.

You know, he put a small pad under my arch and taped my foot that day and it felt soooo good. I wore a bag on my foot in the shower for 2 days just to keep it on:rolleyes: Does anyone know if wrapping it with an ace bandage or soemthing like that would help? I also NEVER walk around barefoot anymore, which kills me but oh well...

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Originally Posted by Jenn

You know, he put a small pad under my arch and taped my foot that day and it felt soooo good. I wore a bag on my foot in the shower for 2 days just to keep it on:rolleyes: Does anyone know if wrapping it with an ace bandage or soemthing like that would help? I also NEVER walk around barefoot anymore, which kills me but oh well...

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Sounds like orthotics with a good arch support (which the pad and "low dye" tape pattern mimic) might be a large part of your answer!

No, an ace bandage won't do it. Ask him to show you the tape pattern, tell him how much you loved it, look into custom orthotics. (plain ol' off the shelf insoles like Superfeet might not be the answer in this case)

My heel pain turned out to be heel spurs and Plantar Fastitus (sp?). I found custom orthotics to be a big help as well as stretching and advil. The orthopedist did offer a cortizone shot in my heel (yuck!) which I will resort to if I have to before my first century ride. I would be interested to hear if your othopedist recommends orthotics in the bike shoes - mine did and it seems to work.

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Originally Posted by Bklynmom

My heel pain turned out to be heel spurs and Plantar Fastitus (sp?). I found custom orthotics to be a big help as well as stretching and advil. The orthopedist did offer a cortizone shot in my heel (yuck!) which I will resort to if I have to before my first century ride. I would be interested to hear if your othopedist recommends orthotics in the bike shoes - mine did and it seems to work.

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I need to take my shoes into him:o He asked me to and I just haven't had a chance. The pain is starting to come back especially after my long ride last weekend. When we get back from vacation I'm taking them to him. Did he give you the orthotic or is it just something you got over the counter?

I got custom Orthotics from the orthopedist, (expensive -- $400 - but covered by insurance) which I put in my regular shoes and the bike shoes. They helped by about 50%.

I found no heel pain after a 30 mile ride Saturday, but some from a much shorter ride Tuesday. Who knows? Walking on concrete sidewalks, which I do a lot here in Brooklyn, seems to aggrivate the heel the most. Stretching does seem to really help, so I do extra after a ride.