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Plantar Fascitis and heel spur

Discussion in 'Biomechanics, Sports and Foot orthoses' started by defalbaire, Mar 18, 2016.

  1. defalbaire

    defalbaire Member

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    Dear Friends,

    I would like to understand if I'm wrong in my way of thinking and treating Plantar Fasciitis and heel spur. My mother tongue is french but I will try to express myself as best as I can.

    Here is how I understand the problem:

    All inflammation has a cause. For me the plantar fasciitis has always been an inflammation of the plantar fascia. I always found a biomechanical cause that stretch the plantar fascia and provoke an hyper solicitation that leads to an inflammation and when the inflammation is chronic the insertion of the plantar on the heel can have a calcification that we call an heel spur...

    I treat about 5-6 patients a week and I always believe that Orthotics are the first treatment because it treat the problem. Other treatments including anti-inflammatory can be combine....

    I just came across this http://www.ncbi.nlm.nih.gov/m/pubmed/12756315/

    And I would like your point of view


    Valery de Falbaire
    Mauritian Podiatrist
  2. drhunt1

    drhunt1 Well-Known Member

    Valery-let me address your question with my own determinations, after years treating this condition. I hope you're able to understand my response, written in English. Doctors are notorious for disseminating information to their patients that is not quite accurate, but allows the doctor to move on to the next patient. Plantar fasciitis is one such example. TRUE plantar fasciitis is rare in my practice. It is inflammation of the plantar fascia midway to its' insertion. What I see more often, however, is pain at the origin...at the plantar calcaneal tubercle. The symptoms are fairly common, as are the complaints, ie., pain with first weight bearing in the morning, pain tends to resolve "fairly" quickly with increased ambulation, only to return to the patient once they begin ambulating again after a period of rest, (ie., lunch). The complaints are like clockwork...they are pretty much the same patient to patient.

    The pain is not caused by any heel spur, (the spur is merely a consequence of the pulling action of the medial slip of the plantar fascia), nor is this problem caused by inflammation of the plantar fascia. Instead, after years of treating this condition, I have realized that the pain is secondary to the pulling of the planter fascia on the periosteum. Therefore, the problem is not called plantar fasciitis in my practice but instead acute plantar calcaneal periostitis...or inflammation of the periosteum. While I was trained to remove large spurs of the plantar calcaneal tubercle in surgery, it wasn't until I began to leave these exostoses intact and remove a portion of the plantar fascia at the insertion, that my patients recovered MUCH quicker, and were happier, by far, then previously. Hope this helps...

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