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Is there more heel pressure in heel pain?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Rica, Sep 21, 2010.

  1. Rica

    Rica Member

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    Most of us assume that yes there is because we always give pts heel pads...but how do we know that that is the problem? i.e. solution=deviate the pressure to ease the pain?
    So my study is about the relationship between heel pain and heel plantar pressures...to see if there is a difference in heel plantar pressure in pts living with heel pain and pts not living with heel pain.
    I have not yet started working on my dissertation but i am doing some research for now. And i would really appreciate it if you would give me your opinion regarding this subject.


    Erica (Maltese student)
  2. B. Englund

    B. Englund Active Member

    Heel pain, MAJOR topic. Maybe you need to be more precise in what diagnosis you will include in your study.

    Look at plantar fasciitis; major cause = strain in the plantar fascia insertion, not of ground reaction forces on the heel. Plantar heel pad will maybe give some relief of symptoms, but do nothing in treating the cause (the strain).

    Plantar fat pad syndrome on the other hand, degeneration of the fat pad sub calcaneus due to impact forces. Plantar heel pad as treatment in order to replace some of the function of the fat pad.

    Both included in the “heel pain” category, however, two different diagnosis with two different etiologies. My tip, be more precise in your research question. Interesting idea for dissertation nonetheless!

    Good Luck!

    Björn Englund
    Karolinska Institute
  3. Dananberg

    Dananberg Active Member


    It has become my impression that it is the duration of heel contact, rather than impact shock, that has the most effect on heel pain, particularly in the plantar fascia. The longer the heel stays in ground contact during the single support phase of the gait cycle, the more the medial arch must lower to accommodate the movement of the body above it. Prolonged heel contact periods can create an environment in which heel pain becomes chronic. Interestingly, using a heel cushion will only serve to lengthen heel contact....and therefore be very poor at addressing plantar fascia type pain.

  4. Rica

    Rica Member

    Thankyou for your advice and support! You have been such great help! I am going to include any type of diagnosis that i will be represented with as my method of sampling will be Convenience sampling (1st through the door). But i shall be excluding pts with certain systemic conditions ex: neuropathic diabetes in order to minimise conditions as much as possible. Thus pts are going to be between 18 and 55 yrs of age. A matched subject design will be used; similarities in age, gender and weight between each pt with/without heel pain. Pts with heel pain will be new cases and the control group should have no history of heel pain.
    Thankyou Howard as you have given me a very very good issue that i can use on in order to stress my point.

  5. Admin2

    Admin2 Administrator Staff Member

  6. Rica

    Rica Member

    Thankyou for this thread! What I thought would be a quick look has lead me to stay for hours on the pc as i've opened other threads and articles as a result. So thankyou very much! So after all do you think that Kevin Kirby is right? Because he has stressed his point that traction is the case in all threads... I am still a student so I cant actually rely on what I think hehe. Thanks again for your feedback.

  7. Erica:

    From my clinical experience and knowledge of foot function/physiology of tissues, I believe that plantar heel pain, of mechanical origin, can be subdivided into one of three groups:

    1. Plantar heel pain caused predominantly by excessive tensile force within plantar fascia and/or plantar intrinsics.

    2. Plantar heel pain caused prodominantly by excessive compression force on plantar calcaneus from ground reaction force.

    3. Plantar heel pain caused by both excessive tensile force within plantar fascia/plantar intrinsics and excessive compression force on plantar calcaneus.

    Hope this helps.
  8. Rica

    Rica Member

    Yes thanks alot! So if i've understood right only tensile force can occur in the plantar fascia. But in other parts of the heel compression takes place. And thus there is a difference in pressure in pts with plantar heel pain (if the plantar fascia is not involved) and pts with no history of plantar heel pain. Therefore heel pads are effective in this case.
    Thanks again for your support!


    Last edited: Sep 28, 2010

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