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How quickly can a heel spur be formed?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by Donna, Jan 24, 2008.

  1. Donna

    Donna Active Member


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    Hi everyone!

    I hope I don't start any arguements here, but just wondering how long on average it takes for a heel spur to form due to an insertional tear of the plantar fascia? We have a patient who was x-rayed by his GP 3 days post-plantar fascia tear of the left foot (querying stress fracture) and a tiny plantar heel spur was visible on the painful side only. He presented here on 17/1/08 for assessment...

    History:
    This very active 59 year old male patient is training approximately 22 hours per week for iron man/triathlon events, on top of his work schedule as a paramedic. He estimates his weightbearing time during work as 20%, and trains heavily on weekends and before/after work, so his waking hours are basically spent either at work or training!

    He reports a sudden onset of heel pain (14/1/08) at the left plantar calcaneus, with pain on palpation at the more lateral aspect of the plantar fascia insertion. He describes the initial pain as sharp, which later spread to the achilles and soleus. The patient is responding well to taping/ice/heel raises/footwear advice/reduced activity, and he will be fitted with custom devices shortly which we are positive will help him get back to his training...

    My question is, would it be likely that the tiny tiny heel spur seen on x-ray was a result of the acute plantar fascia insertinal tear, or is it something that might have probably been there long before the patient present? Is this a case of the chicken and the egg?

    Regards

    Donna :D
     
  2. Donna:

    Radiographically evident calcaneal spurs likely take months or years to form, not days or weeks. However, I know of no research to back up my opinion on this subject. The presence or absence of calcaneal spurs should not be clinically relevant in your patient's case.
     
  3. Donna

    Donna Active Member

    Hi Kevin,

    Thanks for that, I thought that might have been the case that it would take months/years rather than days! We were just curious about how long it does actually take for radiographic evidence of heel stress to occur, and you're right, it has no relevance to the patient's treatment plan as we are treating the tissue stress on the plantar fascia, not the spur... :D

    Sometimes patients ask questions that are difficult to answer... and this was one of them! :bash:

    Regards

    Donna :)
     
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