Dr. Tariq Jagnarine
Family Med, Endocrinology / Diabetes
A heel trigger is a foot condition caused by a bony-like growth, called a calcium deposit that extends between the heel bone and the arch. Heel triggers often start in front of and under the heel. They eventually affect other parts of the foot and can go up to half an inch long. Finding heel triggers can be challenging. Heel triggers do not always cause pain, and not all heel pain is associated with triggers.
SPORT HEEL CASES
Heel triggers are directly caused by long-term muscle and ligament stress. This excessive stress eventually stresses the heel bone (calcaneus) causing spasms. Repeated stress from walking, running, or jumping on hard surfaces is a common cause of heel triggers. They can also develop from wearing shoes that do not offer support. Heel triggers can also be caused by:
• Arthritis
• Bruising the heel
• Excessive body weight
• Badly fitted shoes
• Walkthrough issues
• Wearing flip-flops too often
• Shoes worn out
Many people with heel triggers also have plantar fasciitis. This painful condition deals with the difficult, fibrous tissue that runs between the heel and toes. Having plantar fasciitis increases the risk for eventual development of heel triggers.
HEUR SPUR SYMPTOMS
Symptoms of heel triggers may include:
• Pain
• Heel irritation
• Zoom around the heel
• The affected area may also feel warm to the touch. These symptoms can spread to the bow of the foot.
• Ultimately, a small bony protrusion may be visible.
• Some heel triggers may cause no symptoms at all.
• May cause changes in soft tissues or bones around the heel.
DIAGNOSIS
It is difficult to diagnose a heel trigger without medical help. This is because the symptoms are similar to other types of heel pain and foot problems. Most triggers are detected by X-ray. Bony protrusions are not usually visible to the naked eye. This is why diagnostic imaging tools are essential when testing for any unknown causes of foot pain and inflammation. Physical examination of the foot with no signs of redness or irritation, obvious tenderness on the foot.
SPUR HEEL TREATMENT
Heel trigger treatment consists mainly of rest and lifestyle changes.
• Cold compressions
Using ice packs or cold compresses for up to 15 minutes at a time can help relieve heel trigger pain by temporarily numbing the area. This method also helps to reduce swelling. Cold compressions are better than heat packs for heel triggers because heat works better for joint and muscle aches.
• Injections of anti-inflammatory medicines
For severe pain, doctors may recommend corticosteroid shots. These anti-inflammatory injections help relieve pain and inflammation through the heel and arch of the foot.
• Over-the-counter pain medications
Acute, or short-term, pain can be reduced with the help of over-the-counter (OTC) pain medications. These may include Panadol, aspirin, diclofenac or ibuprofen.
• Physical therapy and stretching exercises
Heel trigger exercises include lengthening the heel muscles and plantar fascia. These can be performed at any time of the day, but stretching can be especially helpful in the evenings before bedtime.
• Rest
Rest is one of the most recommended treatment measures for plantar fasciitis and heel triggers. Not only does rest help ease acute pain, but getting off our feet can also prevent the condition from getting worse. It is especially important to rest the feet after long periods of standing and other activities.
• Orthotic shoe inserts
Orthotic shoe inserts, such as heel pads, can help give the arch and heel the support needed to reduce pain. Heel pads can also prevent further wear and tear. They should be used in addition to proper footwear for general foot protection.
• Heel trigger surgery
Doctors may recommend surgery when heel trigger pain becomes severe and persistent. This type of surgery involves removing the heel trigger. Sometimes it also involves releasing the plantar fascia. Heel-trigger surgery not only reduces pain, but is also aimed at boosting mobility in the general foot. Most people who have this type of surgery also have plantar fasciitis. Due to other types of treatments and therapies available, surgery is not common for heel spasms alone.
• Exercises for heel triggers
Stretching exercises are good methods of general body conditioning because they help you work out sore muscles and tight ligaments while also preventing injuries. The same concept applies to the management and recovery of heel trigger pain. Some types of stretches can help heal pain and inflammation in the heel and calf areas. These include:
• The calf extends against the wall
• The calf extends on steps
• Golf / tennis ball foot rolls
• Sitting foot flex
• Towels clinging to toes
PREVENT HEEL SPURS
• Preventing heel triggers requires more attention to overall foot health. Be aware of the daily stress placed on the feet. Make sure you give them a break at the end of the day. Usually, never push through any heel pain that develops. Continuing to walk, exercise, or wear shoes that cause heel pain can lead to long-term issues such as heel triggers. If you experience heel pain after any activity, freeze the area and give the foot a rest until it heals.
• Choose the right footwear and change running shoes as often as possible. Shoes worn, or shoes that are worn very unevenly (the height is different between the heel and the toe) make a heel trigger more likely.
• Make sure that the surface that used to run is not too hard.
• Keep an eye on weight management; being overweight often puts too much pressure on the heels.
• Running barefoot: start trying barefoot running. It will help avoid landing with excessive pressure on our bones and joints, landing instead on the muscles and fascia. This option is particularly suitable for warmer months, if it cannot run on different surfaces. Some of the best options include grass, moss and sand.
• Regular movement and activation of the foot muscles.
The long-term outlook is generally good. The inflammation usually responds to conservative, surgical treatments, such as anti-inflammatory drugs and orthotics. Rarely, surgical intervention is required.
