Definition

What is a heel spur?

The heel spur (also known as the calcaneal spur) is a bony outgrowth that forms on the heel bone. A distinction is made between the plantar heel spur and the dorsal (or cranial) heel spur. A plantar heel spur occurs much more frequently and is located at the junction where the plantar fascia (also known as the "tendon plate") attaches to the heel bone. A dorsal heel spur is located at the tendon insertion of the Achilles tendon.

Heel spurs can be visualised using an X-ray and a heel spur diagnosis can therefore be made by the doctor. Many people already have a heel spur without it being noticeable or causing heel pain. Unfortunately, however, this bony outgrowth can also lead to injuries and discomfort around the heel area. Although a heel spur as a bony structure cannot be reversed, suitable treatments can significantly reduce pain and improve quality of life.

1. Achilles tendon
2. Dorsal heel spur
3. Heel bone
4. Plantar heel spur
5. Plantar fasciitis
6. Plantar fascia

What is plantar fasciitis?

Plantar fasciitis is an inflammation of the plantar fascia (also known as the plantar tendon or tendon plate). The plantar fascia is a strong band of connective tissue that runs from the heel bone to the metatarsophalangeal joints and supports the arch of the foot. The clinical picture is often incorrectly referred to as a heel spur. However, this is only very rarely responsible for heel pain, which is explained in the next section. Depending on the inflammation and irritation of the plantar fascia, the foot pain can vary. The heel spur and plantar fasciitis can occur independently of each other, but they can also occur together.

Where does the foot pain from heel spurs and plantar fasciitis come from?

The pain around the heel bone and sole of the foot occurs due to irritation of the plantar fascia. The following misuse and overloading can lead to increased tension in the myofascial structures of the posterior chain (including the sole of the foot, calf and posterior thigh muscles). This increased tension stretches the plantar fascia, which can become inflamed and lead to the well-known plantar fasciitis symptoms. Due to the increased tension, the body wants to protect possible weak points from injury and tears. In this case, the transition from the calcaneus to the plantar fascia and the calcaneus to the Achilles tendon are potential weak points. The body protects these areas by reinforcing them with bone-forming cells (osteoblasts). The spur is the result of this. The spur only becomes a problem when it presses on the sensitive soft tissue (e.g. the plantar fascia) around the heel bone, causing additional irritation. This irritation can also lead to inflammation in the heel and sole of the foot, which is known as plantar fasciitis. The causes of plantar fasciitis and heel spurs are explained below. From this knowledge, it can be deduced what the treatment for heel spurs and plantar fasciitis could look like.

Causes of a heel spur and plantar fasciitis

The causes of plantar fasciitis and heel spurs are closely linked to modern lifestyles and changing environmental conditions. In the past, our ancestors had to move more holistically and significantly more in order to obtain food. Hunting, foraging for berries or farming are just a few examples. Over long distances, this movement was carried out barefoot and on natural ground. The surface of the ground and the extent of the movement meant, among other things, that the foot and leg muscles were well developed and naturally strained. Lifestyle has changed considerably over the millennia. Modern civilisation is often characterised by a lack of exercise and a sedentary lifestyle. However, when we do move, it is on hard, flat floors such as concrete or tarmac and in immobile, supportive shoes due to the changed environmental conditions. Consequently, the altered quantity and quality of movement leads to physical adaptations. The effects of this on the development of heel spurs and plantar fasciitis are described below.

Lack of exercise and a sedentary lifestyle

The modern way of life with its lack of exercise and sedentary lifestyle changes the strain on our musculoskeletal system, which leads to corresponding adaptations. These adaptations are therefore a decisive factor in the cause of plantar fasciitis and heel spurs. The following changes play a significant role in the development of plantar fasciitis and heel spurs:

• Weakened muscles
  Lack of exercise and a sedentary lifestyle cause essential muscles to atrophy. The muscles of the foot and lower leg play a crucial role in supporting the arch of the foot and absorbing shock loads when walking and running. When these muscles are weakened, they cannot perform these functions effectively, resulting in increased stress on the plantar fascia.

• Foot malpositions
  The weakened musculature can also lead to foot malpositions. The muscles responsible are no longer able to adequately support the longitudinal arch, which can lead to flat feet or fallen arches. The plantar fascia, which is attached to the heel bone and the metatarsophalangeal joints, is stretched unphysiologically as a result of the lowering. This leads to an increase in tension in the plantar fascia, which can result in irritation and inflammation. A kinked foot can lead to torsion of the plantar fascia due to the heel shifting outwards and the midfoot and forefoot buckling inwards, which in turn leads to incorrect and excessive strain on the tendon plate.

• Fascia dysfunction
  Fasciae change their original structure and can become brittle if they are subjected to irregular and unphysiological strain. This results in tension, adhesions and blockages in the fasciae. As a result, the fasciae no longer function properly and can lead to increased tension in the posterior myofascial chain. The increased tension in turn causes the plantar fascia to be stretched unnaturally, making it susceptible to inflammation and injury.

• Joint stiffness
  Due to a lack of exercise and a sedentary lifestyle, the joints are not moved to the maximum possible range of motion. The result is a natural stiffening of the joints. Immobile joints, especially in and around the foot, increase the force exerted on the plantar fascia, which puts additional strain and overload on it.

Hard, flat floors and immobile, supportive shoes

The changed environmental conditions have a considerable influence on the strain on the musculoskeletal system. The hard, flat floors and immobile, supportive shoes change the biomechanics of every single step and are therefore a decisive factor in the cause of plantar fasciitis and heel spurs. The following changes play a significant role in the development of plantar fasciitis and heel spurs:

• Exposure to force
  When walking on hard, flat floors and in immobile, supportive shoes, higher forces act on the musculoskeletal system, especially when the heel strikes the ground. Due to the firmness of industrial floors and the stiffness of conventional shoe soles, the forces that occur cannot be absorbed, which leads to increased strain on the body. This increased force first affects the feet and therefore also the plantar fascia, which places additional incorrect and excessive strain on it. Furthermore, the increased and early application of force shortens the possible reaction time of the responsible muscles. If the muscles cannot tense in time, the corresponding joint is insufficiently stabilised, which also leads to incorrect and excessive strain. The muscles around the numerous joints in the feet and ankle help to protect the plantar fascia.

• Unnatural sequence of movements
  The hard, flat floors and immobile, supportive shoes make a physiological sequence of movements significantly more difficult. On the one hand, the lack of muscle activation during heel strike (see "Force exerted") causes the foot to fold downwards in an uncontrolled manner. This results in the so-called folding foot. As a result, the plantar fascia is "hit" with every single step instead of being guided in a controlled manner. On the other hand, natural forefoot rolling is reduced. Due to the lack of rolling, the plantar fascia is subjected to increased stress in a reduced area, which can injure and inflame it. There is also no natural stretching of the plantar fascia when rolling over the forefoot, which keeps the plantar fascia supple and elastic and thus protects it from incorrect and excessive strain.

• Weakened muscles
  The passivity of the feet on hard, flat floors and in immobile, supportive shoes also leads to a breakdown of the essential muscles that support the longitudinal arch and protect the foot from foot misalignment. Due to the weakened muscles, the plantar fascia is misloaded and overloaded, causing plantar fasciitis and heel spurs. Walking on soft natural ground (e.g. sand or moss) challenges and stimulates the relevant muscles and thus strengthens the feet.

Symptoms

It is important to note that the following are the most common heel spur symptoms and plantar fasciitis symptoms. However, the list of symptoms is not complete and exhaustive. Atypical symptoms that are not listed here are also possible. Heel spur and plantar fasciitis symptoms often depend on various factors such as pain perception, cause of the injury, degree of injury and physical constitution. In order to obtain a clear diagnosis, a doctor should be consulted.

• Heel pain or pain in the sole of the foot, which can also radiate over the entire sole of the foot.

• Start-up pain when taking the first steps after sleeping or after sitting for a long time.

• Heel pain when stepping with the foot

• Discomfort comes gradually and gets worse over time.

• Pain in the heel and sole of the foot initially only occurs under load.

• Pain in the heel on the inside

• Burning pain, as if a nail or knife is piercing the sole of the foot.

• Inflammation around the heels or in the entire sole of the foot.

• Foot pain when walking in the area of the heel and sole of the foot.

• Pain in the heel or sole of the foot when pulling up the toes and rolling the foot.

• Extreme strain, such as jumping, increases the pain.

Conventional therapies and treatments

There are several approaches to treating plantar fasciitis and heel spurs.

• Rest and relief: To relieve the pain of heel spurs or plantar fasciitis, the affected heel or plantar fascia should be protected and activity reduced. Light exercises for heel spurs and plantar fasciitis can be helpful.

• Exercises: Common plantar fasciitis and heel spur therapy includes stretching exercises to relieve the plantar tendon. These exercises for heel spurs and plantar fasciitis can easily be performed at home without any aids. Targeted exercises can help with heel spurs of both types (dorsal and plantar heel spur treatment).

• Physiotherapeutic treatments: Thanks to special exercises to stretch and strengthen the foot muscles, heel spurs can be treated and the irritated plantar fascia relieved. Manual therapies can release tension and blockages and are therefore a helpful treatment for heel spurs and plantar fasciitis.

• Orthopaedic insoles: Orthopaedic insoles can be a helpful temporary solution for the treatment of heel spurs and plantar fasciitis. The supportive elements of the insoles help to relieve the heel and plantar fascia, which can play an important role in plantar fasciitis and heel spur therapy. The insoles for heel spurs and plantar fasciitis are often equipped with soft material in the painful area so that the sensitive area is relieved.

• Medication: Painkillers and anti-inflammatory medication can help to alleviate the symptoms if the heel inflammation is severe. Explicit plantar fasciitis or heel spur medication is not available. In combination with other measures such as stretching exercises, treatment for heel spurs and plantar fasciitis can be more effective.

• Shock wave therapy: This form of therapy is an effective method of treating plantar fasciitis and heel spurs. This targeted plantar fasciitis and heel spur therapy is particularly suitable for chronic pain and supports the healing process.

• Surgical interventions: In rare cases, heel spur surgery is necessary if conservative treatment for heel spurs or plantar fasciitis has not been successful. The aim of the operation is to remove the heel spur that is causing the constant inflammation and pain. This solution should always be at the end of a series of conservative treatments if these have not led to any improvement.

Unfortunately, these measures often do not lead to a long-term reduction in heel spur pain or plantar fasciitis pain, as the causes for the development of heel spurs and plantar fasciitis are not eliminated. The aim of every heel spur treatment and every plantar fasciitis treatment should therefore be to eliminate the causes. As described above, the lack of exercise, sedentary lifestyle, hard, flat floors and immobile, supportive shoes should be addressed. The How kybun works proves to be a suitable heel spur therapy and plantar fasciitis therapy that can eliminate the causes mentioned.

How kybun works

kybun products aim to eliminate the harmful effects of hard, flat floors and immobile, supportive shoes and actively tackle the lack of exercise and sedentary lifestyle. The elastic, springy properties of kybun products relieve pressure on the feet on the one hand and activate them on the other. The relief ensures that, as a first step, the pain caused by heel spurs and plantar fasciitis in the feet is reduced. Activation is intended to tackle the causes of plantar fasciitis and heel spurs so that the complaints become a thing of the past in the long term. This makes kybun shoes ideal for heel spurs and plantar fasciitis, as they help to treat heel spurs and plantar fasciitis through the following modes of action:

• Optimised pressure distribution thanks to the reduction of pressure points
  The elastic, springy properties of kybun shoes allow the foot to sink deep into the kybun material. This then surrounds the entire foot. Thanks to this optimised pressure distribution, pressure points are reduced. The sensitive areas around the heel spur and plantar fasciitis are thus relieved, which often leads to immediate pain relief. The relief allows the inflammation around the heel and sole of the foot to slowly subside. Furthermore, the constant light movement on the elastic, springy kybun products increases the load-bearing surface, which also reduces localised pressure points.

• Reduction of the force exerted by hard, flat floors thanks to the cushioning effect
  When the heel strikes the ground in kybun shoes, the elastic, springy material is compressed. This rebound effect of the sole means that some of the forces occurring can be absorbed and released again for the rolling phase. The force absorption capacity of the kybun sole leads to cushioning around the heel area and thus protects the plantar fascia from excessive force. The reduced force reduces the load on the feet, which reduces the risk of inflammation of the sole of the foot and promotes healing of the already inflamed plantar fascia.

• Activation of the foot muscles through elastic-spring properties
  On the elastic-springy kybun shoes, the feet are constantly moving slightly and have to stabilise their balance. This activity trains the foot muscles. On the one hand, trained foot muscles can stabilise the ankles under load and thus reduce the force exerted on the plantar fascia. On the other hand, activating the foot muscles also addresses foot misalignments, which can favour heel spurs or plantar fasciitis. The lowering of the longitudinal arch and pronation in particular lead to additional strain on the plantar fascia.
  Furthermore, the musculoskeletal system has more time to react due to the slow sinking of the heel into the elastic-springy material, as the full application of force is delayed and reduced. By delaying the application of force, the corresponding muscles can tense up in good time and thus stabilise the foot during heel strike so that the plantar fascia is not misloaded or overloaded.

• Natural foot rolling thanks to muscle activation and rolling function
  The aforementioned delayed application of force with the associated muscle activation means that the foot does not roll downwards uncontrollably after heel strike, but can roll physiologically. This protects the plantar fascia from uncontrollable strain. Furthermore, the elastic, springy sole with roll-off function enables a natural rolling movement over the forefoot. The associated increase in the range of motion slightly stretches the plantar fascia with every step, which keeps it flexible and therefore resistant to strain. A flexible plantar fascia reduces the tension on it and thus protects against inflammation-promoting processes.

• Protection against fascial dysfunction thanks to a physiological sequence of movements
  Thanks to the slow sinking in during heel strike and controlled rolling, a physiological gait is made possible, which also protects the fascia from structural changes. A functioning fascia network reduces tension in the plantar fascia and protects it from incorrect and excessive strain.

• Improved circulation through increased movement activity
  The increased movement activity and amplitude in kybun shoes leads to increased circulation in the feet, as the muscles involved need to be supplied with oxygen. The plantar fascia is also better supplied with nutrients and remains resilient. The increased blood circulation also helps to transport the body's own anti-inflammatory substances to the plantar fascia more quickly and more effectively and to remove the substances that promote inflammation more easily. As a result, the tissue is less prone to inflammation and can heal more quickly.

Application tips

Before you wear kybun shoes for the first time, you should consider a few tips for use. The correct use of plantar fasciitis and heel spur shoes can help to alleviate the symptoms. Plantar fasciitis and heel spurs can also be treated with targeted plantar fasciitis and heel spur therapy, which is explained in the next section.

• To begin with, only wear kybun shoes for as long as your body allows. Take breaks from wearing them if the pain from the heel spur or plantar fasciitis increases or the musculoskeletal system becomes fatigued. Heel spur treatment and plantar fasciitis treatment take time. The activating properties of kybun products train the muscles, which can lead to so-called initial reactions, especially at the beginning.

• Press your heel slowly and in a controlled manner into the elastic, springy material so that the plantar fascia is relieved. Try to find a load point at which the pain around the heels is reduced or does not occur. At the beginning, make sure that you do not roll too much over your heels.

• Start by taking small, controlled steps, reducing the amount of rolling over the forefoot so that the plantar fascia is not additionally stretched. Increase the range of motion of the feet over time, if possible.

• Try the following exercises to boost the effectiveness of kybun shoes and increase the likelihood of recovery. These are intended as a complementary therapy for heel spurs and plantar fasciitis.

Helpful exercises for heel spurs and plantar fasciitis

To enhance the effectiveness of kybun shoes and increase the likelihood of recovery from foot pain, we recommend the following exercises for heel spurs and plantar fasciitis. The selection of exercises is not exhaustive and can be supplemented with other plantar fasciitis and heel spur exercises. The basic rule for all exercises is that the pain around the heels and plantar fascia must not get worse. If one of the exercises increases the pain of the heel spur and plantar fasciitis, it must be discontinued. Soothing and releasing "pain" outside the pain point of the heel spur and plantar fasciitis (e.g. in the calf) is desirable.

The plantar fasciitis and heel spur exercises are divided into the following areas: "Correct walking in kybun shoes", "Muscle length training", "Fascia rolling" and "Strengthening". Ideally, the different areas should be used as complementary therapy for heel spurs and plantar fasciitis.

Walking the right way in kybun shoes

The quality of each individual step is crucial in the treatment of heel spurs and plantar fasciitis in order to reduce pain and eliminate incorrect and excessive strain. The kybun shoes therefore offer ideal therapy for heel spurs and plantar fasciitis.

Controlled heel strike

• Press the heel carefully and in a controlled manner into the elastic-springy material to determine the load strength and point at which stepping is possible or the heel pain is reduced when stepping.

• Controlled foot position so that the foot does not tilt inwards or outwards.

• Lower the midfoot and forefoot slowly and in a controlled manner so that the plantar fascia is not excessively irritated.

• Active rolling over the forefoot should not yet be performed here. The focus is on physiological heel strike.

Controlled rolling

• Easy rolling in the forefoot without actively pushing off with a lot of force via the big toes. Active rolling would cause additional stretching of the plantar fascia and Achilles tendon, which can cause additional irritation in the case of existing injuries.

• Test the possible range of movement of the feet without causing pain from the heel spur or plantar fasciitis. Increase the range of motion if possible.

Muscle length training

Muscle length training is of crucial importance in the treatment of heel spurs and plantar fasciitis, as irritation of the plantar fascia is often caused by shortening and tension in the posterior chain (including the sole of the foot, calf and posterior thigh muscles). Targeted plantar fasciitis and heel spur stretching exercises can actively address the shortening and tension and therefore represent an ideal plantar fasciitis and heel spur therapy.

Calf muscles

• Starting position in a lunge.

• The back heel is in contact with the ground and should not be lifted.

• Slowly bend your front knee forwards until you feel a pull in your calf.

• 3 x 30 Sekunden pro Seite.

• Perform 1-2 times daily.

Calf and hamstring muscles

• Starting position in four-footed stance.

• Stretch your buttocks upwards into the air.

• If possible, push your heels towards the floor to increase the stretch.

• Hold the exercise for 3 x 30 seconds.

• Perform 1-2 times daily.

Fascia roller

Fascia training with the fascia roller is important in the treatment of heel spurs and plantar fasciitis, as the irritation of the plantar fascia is often caused by shortening and tension in the posterior chain (including the sole of the foot, calf and posterior thigh muscles). By regularly rolling out the shortened and tense myofascial chain, the fascia roll can be used as active plantar fasciitis and heel spur therapy.

Foot sole

• Actively roll out the sole of the foot with a fascia roller or ball from the heels to the toes.

• Perform the exercise slowly and in a controlled manner.

• Adapt the pressure to your personal feelings, but go as far as the tolerable pain threshold.

• Roll out any localised adhesions or hold the position at this point.

• At least 3 minutes per foot.

• Perform 1-2 times daily.

Calf muscles

• One leg bent and the other leg on the fascia roll. Increase the pressure by placing the legs on both sides. Further increase by placing the legs on top of each other.

• If you experience pain in the wrist, the exercise can also be performed on the forearms.

• Actively roll out the calf above the heel to just below the hollow of the knee.

• Perform exercises slowly and controlled.

• Adapt the pressure to your personal feelings, but go to the tolerable pain threshold.

• Roll out any localised adhesions or hold the position at this point.

• At least 3 minutes per side.

• Perform 1-2 times daily.

Strengthening

Specialized foot strength training is important for foot deformities (particularly flat feet and plantar fasciitis) to protect the plantar fascia from excessive strain. Strengthened muscles support the management of heel spurs and plantar fasciitis by reducing the stress on the foot's sole and promoting recovery. Thus, it provides an effective treatment for heel spurs and plantar fasciitis, helping to alleviate pain over the long term.

Foot muscles Longitudinal arch

• Stand upright and hip-width apart

• Heel and ball of foot have even contact with the ground.

• Slowly straighten the longitudinal arch without the heel or the ball of the foot losing contact with the ground.

• Also make sure that the movement comes from the feet and that the lift is not caused by the external rotation of the knees.

• Hold the position for 4 seconds at the highest point.

• Lower the foot again slowly and in a controlled manner.

• 3 sets of 8 - 12 repetitions per foot.

• Perform 2 - 3 × weekly.

Before

After

Foot muscles Transverse arch

• Lay the towel on the floor

• Stand upright and hip-width apart. The exercise can also be done sitting down to make it easier.

• Pull the towel up with the toes of one foot.

• Reposition the towel at the end point

• 1 - 2 minutes per side per foot.

• Perform 2 - 3 × weekly.