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heel spur

Heel Spurs

Healthy feet have a longitudinal and a transverse arch. The weight of our body is dynamically distributed with each step from the heel over the arch of the longitudinal arch, the metatarsal bones and the transverse arch in the forefoot. It comes to a rolling motion.

Longitudinal and transverse vaults are braced by strong muscles and ligaments. As a result, they achieve high stability. The vault makes the foot resilient and, to a degree, flexible. This protects him, for example, from wear.

To prevent the arch of the foot becoming flattered, it is spanned by a tendon plate called the plantar aponeurosis. It rises from the inner part of the heel bone and then turns into straps attached to the toes. The tendon plate is made of fibrous material. If it is permanently overloaded, for example, by long-running or standing on hard floors, obesity, foot deformities such as kinking foot, wrong and bad footwear or lack of warm-up phases during training, the plantar fascia can become inflamed. It creates too much pressure on the tendon plate. 

In the tendon plate, microcracks may form on the overstressed portions. The surrounding tissue is chronically inflamed. As a result, lime deposits here, which closes the cracks and virtually stabilizes the tendon plate. This is how the bone spur arises.

heel spur

What is the heel spur?

A heel spur usually causes uncomfortable, sharp pains in the heel area. Especially in the morning after getting up, they are often very violent. One has the feeling of having stepped on a nail. The pain usually subsides after a few steps.

A heel spur is detectable by X-ray only in about 10% of the population. As often no discomfort occurs, a heel spur often goes undetected and becomes noticeable only through pain during prolonged overload. The symptoms worsen significantly during longer running. Pain is also running on hard ground.

Diagnosis:

A heel spur can grow up to ten millimeters. It is diagnostically detectable by applying pressure to the middle of the heel bone during palpation. This leads to a pain sensation. If no heel spur is detectable in the X-ray, computerized tomography (MRI) may detect chronic inflammation of the tendon plate.

Who is particularly vulnerable?

  • Long-distance runner
  • Weekend runners in middle age: Fat pads in the heel are almost “shock absorbers”. They shrink with age.
  • Overweight
  • People with untreated misalignment (kink-dropping) of the foot

How to prevent a heel spur

If exercising regularly, you should protect your feet from being overworked. Take time to warm up and stretch before sport. Equally important are stretching exercises, even after exercise.

Pain in the heel is usually a sign of congestion. Sport should be avoided in the pain phase. Rest the foot and cool the heel with ice.

Overweight people should try to reduce their weight. As a result, the arch of the foot can be relieved considerably while walking.

How is a heel spur treated?

There are several non-surgical methods to successfully treat a heel spur:

  • Insoles: They prevent direct contact between the heel and the floor when walking. This relieves the painful point on the heel.
  • Physiotherapy: stretching exercises, physical therapy
  • Shock wave therapy: concentrated high-energy sound waves are directed at the painful point
  • Special rails: They are worn at night and pull (stretch) the forefoot about 5 ° in the direction of the head.
  • Anti-inflammatory drugs for support

If conservative treatments are not successful, surgery is the last resort.

runner knee

Runners Knee – Tractus Syndrome

How does a runner knee notice?

After walking for a while, pain on the outside of the knee occurs. During running, the pain intensity then increases, so you have to cancel the running unit. After completing running, the pain usually disappears. The normal everyday stress usually does not cause any pain. Swelling or overheating of the knee joint, which would indicate tissue inflammation, is rare.

How is a runner’s knee created?

To ensure that the movement in the knee joint runs smoothly and the knee joint can withstand even extreme loads, the perfect interaction of all involved structures such as bones, cartilage, ligaments, capsule, menisci, and muscles is enormously important.

Coming from the hip, a tendon plate, also called the iliotibial tract, runs over the thigh and knee to the outside of the tibial head. With each movement, this tendon plate shifts over the prominent outer edge of the knee joint. In a long-distance run, this repetitive and uniform motion is then performed thousands of times. Overloading (intense running) and/or misloading (for example, improper running style) can irritate the tendon plate. The runner’s knee is thus an overload of conditional irritation on the outside of the knee joint.

runner knee

One cause of the runner’s knee is often found in those affected in the mostly shortened muscles in the hip area. This causes the tendon plate to move with increased tension over the outside of the knee joint. The overused tissue then ignites. Other causes of the Runners’s knee are also misalignments of the leg axes, such as O-legs, X-legs, malformations of the foot as Senkspreiz- or hollow foot and wrong running shoes.

The diagnosis of “runner’s knee” can often already be made by the anamnesis and the targeted examination of the knee joint and the musculature. Ultrasound, MRI and X-ray of the knee joint are rarely necessary, to exclude, for example, a meniscal tear, cartilage damage or a fatigue fracture.

Therapy of the runner’s knee

  • Reduction of running
  • Cooling of the knee and anti-inflammatory ointment in the acute phase
  • intensive stretching of the musculature of the hip outside several times active (can be done independently)
  • targeted physiotherapy (as support) with gymnastics, transverse frictions, possibly electrotherapy
  • Cold therapy for local metabolic stimulation, alternating baths or heat packs (can be done independently)
  • Anti-inflammatory tablets or injections with metabolism-stimulating or regenerative substances should only be prescribed in severe cases.
  • Checking the running shoes and the running technique as well as compensation for any misalignments of the leg axes or feet, for example by means of suitable running shoes and / or special insoles.

When the acute symptoms have subsided, a light running workout can be started after about 2 weeks.

How to avoid a runner’s knee …

  • Avoid excessive and incorrect loading of the knee joints
  • Stretching before and after exercise (stretching the outside of the leg, for example, by crossing over the legs when standing and tilting the torso laterally)
  • Gradually increase the scope and speed
  • adequate regeneration times
  • suitable, customized running shoes
Achilles Tendon Injuries

Achilles Tendon Injuries

The Achilles tendon is one of the most vulnerable tendons for injuries. As a rule, even a small amount of force is sufficient, since there are usually wear-related prior damages. Rarely, a crack occurs due to direct, sharp violence. Often affected are footballers, but also amateur athletes around the age of 40 years, who usually without appropriate prior knowledge, exercise or warming up their sport. Explosive muscle contractions trigger sudden, extreme tensile and shear forces. The tendon can tear completely or incompletely.

The Achilles tendon connects the heel bone with the calf muscles. It only has a length of 10-12 cm and is practically inextricable. With a diameter of 0.5-1 cm, it withstands a tensile load of 500 kg / cm under static load up to 1,000 kg / cm under dynamic load. In running and jumping, the tendon is loaded up to 9 times the body weight. Mostly, the tendon tears 2-6 cm above the attachment to the heel bone in the transition region of muscle and tendon. But it can also lead to a tear at the attachment of the tendon on the heel bone.

Achilles Tendon Injuries

The Achilles tendon is poorly supplied with blood. Heavy stress can lead to small tears and inflammations. Because of the poor circulation, they heal slowly. Frequently occurring accompanying pain is usually trivialized, resulting in a chronic state of irritation in the area of ​​the heel (achillodynia). An Achilles tendon rupture can be the result.

Symptoms:

  • whip-like pain in the middle of the movement (jump, sprint), also as a punch or knife touch felt
  • often at the same time loud popping noise
  • The pain usually lags quickly
  • Walking is impossible, as well as walking on your toes
  • with fresh injury palpable dent at the tear

In Achilles tendonitis, the Achilles tendon is swollen in its entire length. In case of an incomplete (partial) tendon tear, a small knot can be felt at the injured site. The distinction is difficult.

Athletes are recommended for surgical treatment. The Achilles tendon is restored with various special suture techniques. Healing usually takes six to twelve weeks because of poor circulation. The full everyday workload is usually reached again after 3 months. Conservative treatment by gypsum treatment over six weeks is even more protracted and involves many risks due to immobilization. So it can lead to a breakdown of the musculature, scar adhesions and growths or joint stiffening.

A physiotherapeutic treatment follows. This is primarily about maintaining and rebuilding muscles, coordination and endurance.