Plantar fasciitis involves pain at the insertion of the plantar fascia on the medial calcaneal tubercle. Plantar fascia is a long rope like structure that supports the arch of the foot. Plantar fasciitis involves chronic degeneration at the insertion of the plantar fascia. Non-supportive footwear, flat feet, high arched feet, sudden increase in activity, overweight, trauma, hormone problems, connective tissue disorders increase the risk for the development of plantar fasciitis.
Treatment: Shockwave therapy, custom molded orthotic, ultrasound guided injection therapy, stretching exercise, physical therapy, taping, night splint, surgery
Insertional Achilles Tendinopathy is a chronic overuse injury at the insertion of the Achilles tendon. Certain factors increase the risk of the development of insertional achilles tendinopathy including bony irritation, fluoroquinolones, non supportive shoegear, flat feet, high arch feet, trauma, overweight, sudden increase in activity, hormone problems, connective tissue disorders.
Treatment: Orthotic, shockwave therapy, stretching, taping, night splinting, surgery
Subcutaneous Calcaneal Bursitis
Subcutaneous calcaneal bursitis is an inflammation of the bursa that lies at the back of the heel. Non-supportive shoe gears, tight fitting shoes, flat feet, high arched feet, overweight, trauma, sudden increase in activity, connective tissue disorders increase the irritation of the subcutaneous calcaneal bursa.
The sural nerve runs along the outside of the ankle joint. Sural nerve impingement is a compression neuropathy of the sural nerve. Scar tissue, trauma, cyst can cause sural nerve impingment
Treatment: Orthotic with a lateral rearfoot post, shockwave therapy, surgery, aspiration of cyst.
Severs Disease
Severs disease is called calcaneal apophysitis. It is an inflammation of the calcaneal growth plate. The heel’s growth plate is sensitive to repeated running and pounding on hard surfaces. The pain is common after exercise and can happen in one leg or both legs. It can happen between the ages of 8 to 13 for girls and 10-15 for boys.
Treatment: Activity reduction, orthotic, heel raises, gel pads, supportive shoe gear, stretching, night splint, taping.
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