Therapy/treatment | Physiotherapy for heel spurs

Therapy/treatment

The therapy of a calcaneal spur, as well as the individual treatment plan and the measures taken always depend on the type and severity of the calcaneal spur, the age of the patient, as well as his or her previous illnesses. In general two possible forms of therapy can be distinguished. Both have as primary goal the pain treatment and the fight against the cause.

Conservative therapy

This type of treatment attempts to treat the heel spur without an operative measure. There are many different possibilities for this. On a pharmaceutical level, this can initially be successful symptomatically with the help of anti-inflammatory and analgesic drugs.

The use of homeopathic medicines, especially Hekla Lave D3, has also led to good results in the treatment of heel spurs in the past. However, a far greater part of the therapy of a calcaneal spur is the physiotherapeutic treatment, in the course of which the cause that contributed to the development of the calcaneal spur is clarified and treated. These can be, for example, foot malpositions, overloading, shortened calf muscles or incorrect footwear.

In the course of the therapy we then try to work on these problems in order to eliminate the current problem and to prevent the renewed development of a heel spur. The acute pain associated with a heel spur can easily be controlled with manual therapy, cold, electric and shock wave therapy.The performance of strengthening and stretching exercises for the affected foot is an essential part of the treatment, as they stabilize the structures in the foot and stimulate important metabolic processes that ensure faster healing. Manual therapy can be used very well in the case of a heel spur to delay or prevent surgical treatment.

Manual therapy can include, for example, a trigger point massage, during which special points under the sole of the foot are pressed for about 30-60 seconds to reduce the tension of the muscles. In addition, the heel bone can be mobilized against the surrounding bones in order to achieve better mobility and rollover. Mobilization of the metatarsus is also part of the manual therapy for heel spurs.

Usually several applications are necessary in manual therapy to achieve an improvement. In addition, a separate stretching and exercise program should be carried out. Cold therapy describes various applications in physical therapy that can alleviate the symptoms of a heel spur.

This includes for example the use of ice packs, ice lolly, cool packs or crushed ice. The cold applications have an analgesic and decongestant effect even after a short period of application. In addition, every cold therapy initially has a vasoconstrictive effect, which means that swelling is reduced or prevented.

Furthermore, cold therapy can reduce inflammatory processes in the tissue. Since the complaints with heel spurs are often due to an inflammatory process around the bone attachment, the complaints can be effectively alleviated in this way. After the cold application, the treated area is supplied with more blood, which can accelerate the healing process.

Electrotherapy is also part of physical therapy and can also alleviate the symptoms of heel spurs. Iontophoresis, for example, can be used to relieve pain and inhibit inflammation. Here, two electrodes are attached to the opposite sides of the calcaneus and direct current is applied.

The anti-inflammatory and analgesic effect of the current can be enhanced by medicinal gels containing active ingredients such as diclofenac. These can be introduced under the skin by iontophoresis. Another possibility of electrotherapy for heel spurs is ultrasound therapy.

The high-frequency ultrasound waves have analgesic and anti-inflammatory effects and can loosen minor calcifications around the tendons and bone. If physical therapy has not been able to alleviate the symptoms, shock wave therapy can be used for heel spurs. The therapy device generates shock waves (ultrasound waves) with high energy, which can penetrate deep into the tissue.

The pressure waves are passed on until they hit a foreign body and then unfold their effect. The aim of shock wave therapy is to loosen minor calcifications around the tendons and thus restore the gliding ability of the muscle and tendons. In addition, shock wave therapy stimulates tissue healing by increasing the formation of the body’s own messenger substances.

Usually, this requires about 2-3 applications of shock wave therapy. In order to prevent heel spurs or to alleviate the symptoms, it is important to train the foot muscles and stretch the tendon plate under the sole of the foot. For this purpose, there are various exercises that can be performed by the patients themselves.

For this exercise, place the foot completely on the floor. Then tilt it onto the outer edge and slowly bend the arch of the foot and put it straight again. 10 repetitions.

For this exercise, sit on a chair and place a small towel or washcloth on the floor in front of your feet. Now grab the towel with your toes and lift it. Then drop it and pick it up again.

10 repetitions. Sit on a chair and let the affected foot slowly slide over a hedgehog massage ball. This will loosen tense structures and stimulate the muscles.

Sit on the floor with your legs stretched out. Form a sling with a towel while placing the affected foot in the middle. Now pull the towel with your hands towards your body so that you feel a stretch in the calf muscles.

Hold this for 30 seconds. Sit on the front edge of a chair for this exercise. Push the affected foot under the chair as far as possible, so that the toes are stretched out as much as possible (similar to the walking movement).

Find the point that is painful for you and hold this position for 20 seconds.More exercises: Stretching For stretching, for example, a cloth can be tied around the forefoot as a loop. The leg is stretched out forward in the long seat and the foot is pulled at both ends of the cloth so that the sole of the foot and the calf are stretched. A tennis ball or hedgehog ball can also be used for stretching, over which the foot can be rolled while standing, under the weight of the body.

Strengthening To strengthen the foot muscles, a towel can be used, which must be lifted from the floor 15 times with the toes. The following exercise helps to stretch and simultaneously strengthen the calf muscles: Stand on a step, only the forefeet are on the step, the heels are hanging in the air. The heels sink until the sole of the foot is clearly stretched, then both feet press the weight up to the tip of the toes and the exercise is repeated.

More exercises can be found in the article: Exercises with a heel spur

1. For this exercise, place the foot completely on the floor. Then tilt to the outer edge and slowly bend the arch of the foot and put it straight again. 10 repetitions.
2. For this exercise, sit on a chair and place a small towel or washcloth on the floor in front of your feet.

   Now grab the towel with your toes and lift it up. Then drop it and pick it up again. 10 repetitions.

3. Sit on a chair and let the affected foot slowly slide over a hedgehog massage ball.

   This will loosen tense structures and stimulate the muscles.

4. Sit on the floor with your legs stretched out. Form a sling with a towel while placing the affected foot in the middle. Now pull the towel with your hands towards your body so that you feel a stretch in the calf muscles.

   Hold this for 30 seconds.

5. Sit on the front edge of a chair for this exercise. Push the affected foot under the chair as far as possible so that the toes are overstretched (similar to the walking movement). Find the point that is painful for you and hold this position for 20 seconds.