Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

plantar fascia pathology and heel wedge

Discussion in 'Biomechanics, Sports and Foot orthoses' started by defalbaire, Nov 3, 2016.

  1. defalbaire

    defalbaire Member


    Members do not see these Ads. Sign Up.
    Dear all,

    I would like your advise on heel wedge to treat a plantar fascia pathology.

    I have great results using full orthotics with cast in neutral position, correction regarding my exam, and offloading of the place of the pain if the pain is more than 7/10.

    But my French collegues still use heel wedge to treat plantar fascia pathology that they still call heel spur.

    I would like some real arguments to express my thoughts without any lie.

    I know and please tell me if I am wrong that we have found the following:

    - The heel spur is not in the plantar fascia but the intrinsique muscles.

    -The heel spur could still be a traction spur...

    -The name plantar fsciatiis should no be used anymore because it has been proven that they are no sign of inflammation in a plantar fasciatiis

    -The muscle Triceps Sural is related to the. Plantar Fascia through the paratenon of the Achilles Tendon

    -There is a relation between Achilles pathology and plantar fascia pathology

    So could you explain me the following:

    Because the M. Triceps Sural is related to the plantar Fascia do you think an heel wedge reduce the traction of the plantar fascia by reducing the traction of Achilles Tendon? If yes don't you think that this is just a short term treatment, has it will not correct any deviation and the muscles would start stretching again?

    Do you think that the plantar fascia pathology cause in some case could only be a hypoextensibility (retraction) of the m. triceps sural?

    I beleive that there is not a specific orthotics for a specific pathology.

    I must admit that I still explain to my patients that a plantar fascitiis because all doctors still use this name is a traction of the plantar fascia on his insertion on the calcaneum due to a bad torsion stj/mtj, or an overpronation... depending of my exam. I still say that the heel spur is not the cause of the pain but only show us a big inflammation...

    But the heel spur does not show a big inflammation causing a calcification? The heel spur is not a calcification but what is it?

    I love this topic because I treat about 10people a week with plantar fascia pathology and I use treat because I have excellent results with my orthotics.

    It just really annoyed me to see that my French collegues still beleive only in heel wedge to treat this pathology.


    Thank you for your help and responce!

    Regards

    Val
    From Mauritius
    Sorry for my english but hope you can understand me
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    8
    Hi Val

    Just to clarify, what do you mean by "heel wedge" - different people mean different things. Heel raise? Medial wedge?
     
  3. efuller

    efuller MVP


    I've heard people talk about how the fibers of the Achilles are continuous with the fibers of the plantar fascia and this makes them functionally connected. They are functionally connected in that they both attach to the calcaneus, but there is no sliding of the fibers over the bone, so there is not really any significance to the connection of the fibers.




    Many years ago Hicks showed that increased tension in the Achilles caused increased tension in the plantar fascia. He elegantly demonstrated that the increased tension in the plantar fascia was from an anterior shift of center of pressure under the foot and this increases the bending moment on the foot. The increased bending moment is resisted by increased tension in the fascia.

    Nigg did a study looking at plantar fascia tension with and without heel lifts. He found that the peak tension was the same with and without lifts. Which makes some sense when you look at walking, because the tension comes from muscle contraction and we will contract our calf muscles whether or not there is a heel lift. However, there may be decreased time of higher tension. Or, it may be easier to balance, while standing, with less tension in the tendon.

    I disagree. Some feet need increased supination and some feet need increased pronation. (Medially deviated versus laterally deviated STJ axes) These feet need different design features in their orthoses.

    I too, still like the idea that high tension in the fascia is the cause of heel pain because it makes so much mechanical sense. I agree that pronation will tend to cause increase in tension of the plantar fascia. However, there is more than one cause of pronation.

    Eric
     
  4. defalbaire

    defalbaire Member

    Thank you eric for your answers. I realize that soemtimes I am not really inderstood because of my english ;).

    Thank you for the time you took to reply to my questions!

    I was actually talking about heel lift and you got my point.

    I was also saying that I beleive in different orthotics designs for a same pathologie.
     
  5. defalbaire

    defalbaire Member

    D
    Dear Craig, I meant Heel LIFT
     
Loading...

Share This Page