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Plantar fasciitis Effective relief for chronic heel
and ankle pain

Issue 03/2016

Chronic heel pain on the sole of the foot is a problem seen frequently by orthopedists in their day-to-day work. Treatment with foot orthoses aims to relieve the painful area while supporting the foot arches.

Prof. Dr. med. Markus Walther, Medical Director and Head Physician at the Center for Foot and Ankle Surgery at the Schön Klinik München Harlaching.
Prof. Dr. med. Markus Walther, Medical Director and Head Physician at the Center for Foot and Ankle Surgery at the Schön Klinik München Harlaching.

As many as one in ten adults in Germany suffers from stabbing pain in the heel area that is usually due to plantar fasciitis, the most common cause of chronic heel and ankle pain. “In this disorder, the band of connective tissue in the sole of the foot becomes inflamed at the site where the plantar fascia attaches to the bone. This is generally because the fascia loses elasticity over the course of a person’s life. The symptoms frequently occur between the ages of 40 and 60,” explains Prof. Markus Walther, Medical Director and Head Physician at the Center for Foot and Ankle Surgery at the Schön Klinik München Harlaching. “Increased mechanical loading is often the trigger. The risk rises in cases of a high-arched foot , a flattened longitudinal arch with hindfoot valgus, and shortened calf muscles, for example.” Being overweight can also exacerbate the problem.

Calcaneal spur more of a secondary phenomenon

When people talk about chronic heel and ankle pain, they automatically mention calcaneal spurs. However, the bony spur that constantly appears in X-ray images and has been referred to as the cause for a long time is now considered more of a secondary phenomenon. This is because the plantar calcaneal spur itself, which develops when calcareous material is deposited at the tendon insertion point , often does not pose any problems at all. It is only when the transition between the fascia and bone becomes inflamed that patients feel pain.

Rapid pain relief

“Plantar fasciitis often starts slowly,” says Prof. Walther from experience. “At first , the symptoms only occur during loading in many cases, then typically in the morning when taking the first few steps after getting up,” he continues. The provision of foot orthoses plays a significant role in conservative treatment , as the foot and ankle expert explains: “Relieving pressure in the insertion area of the plantar fascia while also correcting the position of the foot and providing a recess along the length of the fascia is highly effective. This is required to avoid creating additional tension in the plantar fascia as a result of the foot orthosis.” In a study, Prof. Walther has confirmed the effectiveness of the ErgoPad redux heel (see ref.). The specially developed core not only achieved a significant reduction in maximum pain – this effect also began much sooner than with other foot orthoses investigated. As well as the provision of a suitable foot orthosis, the Munich-based foot specialist also always advises the use of concomitant physiotherapy to improve the elasticity of the calf muscles and the plantar fascia by doing appropriate stretching exercises.

The peculiarity of ErgoPad redux heel lies in its construction and the specially shaped orthotic core.
The peculiarity of ErgoPad redux heel lies in its construction and the specially shaped orthotic core.

 

Ref.: Walther M, Kratschmer B, Verschl J, Volkering C, Altenberger S, Kriegelstein S, Hilgers M: Effect of different orthotic concepts as first line treatment of plantar fasciitis. Foot and Ankle Surgery (2013) 19:103–107.

Pictures: Bauerfeind, Rainer Brinkschulte