What are heel spurs?

A heel spur is a condition that occurs when a bone-like formation forms in your feet between your heel bone (calcaneus) and your arch. This begins underneath your heel and is often not visible and requires an X-ray to see the heel spur. Heel spurs in most cases are actually not a cause for concern and do not directly cause pain, they are usually a symptom of a muscle or plantar fascia pulling on the heel bone (calcaneus). When trying to treat heel spurs, podiatrists consider the cause of the condition.

What causes heel spurs?

Heel spurs are caused due to muscles, tendons, and fascia pulling on the bone causing strain. This strain causes the bone to extend and form new bone. This occurs over time and is usually in response to untreated conditions like plantar fasciitis which can cause heel pain.

Conditions that can cause heel spurs to include:

• Plantar fasciitis - When the plantar fascia (a band of tissue along the bottom of your foot) is strained this results in the fascia pulling on the heel bone resulting in a heel spur. This is the most common cause of heel spurs.

• Excessively pronated foot type - A pronated foot type may put more strain on the structures on the bottom of your feet and heel which may result in the development of heel spurs.

• Repetitive strain from walking, running, and jumping - Physical activity which adds strain to your heels and the bottom of your foot may cause heel spurs due to increased force on these structures.

• Flexible shoes - Wearing shoes that are too flexible (such as popular flexible runners or ballet flats) may actually increase your risk of developing a heel spur as they may not provide enough support.

• Ill-fitting shoes - Shoes that do not support you or fit your feet appropriately may increase strain on your feet and may increase your risk of developing a heel spur.

• Flip-flops - These shoes are easy to get on but result in extra strain on the plantar fascia as your toes need to work harder and your heels are inadequately supported.

• Arthritis - This condition affects the joints on your feet and may result in inflammation in your joints on the bottom of your foot.

• Bruising of the heel - Longstanding and repeated trauma to the bottom of your heel may increase your risk of developing a bony formation such as a heel spur.

• Excess body weight - Extra weight puts additional strain on your feet and your heels are no different, this can result in the development of additional bone in response to the pressure.

• A health kick - Sometimes when you increase your physical activity and decide to be fit you may develop a heel spur, this is because your body is not ready to take the increased load on the bottom of your feet. This may trigger plantar fasciitis and therefore heel spurs.

Who is most prone to get heel spurs? Is it curable? How about treatable?

Those with plantar fasciitis are most likely to get heel spurs. Women, those over 40, individuals with flat feet (pronated) are most likely to develop the condition. Men, teenagers, and those with high-arched feet can develop the condition too!

Heel spurs are treatable and the cause may be treated with the appropriate evidence-based interventions. If the cause is plantar fasciitis, this includes a plantar fascia loading exercise and orthotics (orthoses).

What are some qualities you should look for in a pair of shoes to help with heel spurs?

Some features to look for in shoes when you have heel spurs (and generally):

• Supportive heel cup - A shoe with a supportive heel cup can reduce the strain on the heel when walking. A supportive heel cup is when the fabric on the back of your heel is firm, holds the bottom of your heel, and reduces the shoe slipping off your foot.

• Firm rearfoot - When the shoe does not bend easily under your heel, that is when the rearfoot is firm. If the shoe is flexible in the back part of the bottom of your shoe it can cause extra strain.

• Flexible forefoot - The front of your shoes should be more flexible and bend at the toes, this helps you to propel forward smoothly and without applying extra strain.

• Cushion - Some cushioning in the sole of the shoe is great! It is important to get a balance. If the cushioning is too soft it may cause extra strain. It is important to get a sole which is responsive (bounces a bit) and cushioned so that it can help you propel forward.

• Comfort - The shoes you wear should be comfortable and you should be able to enjoy wearing them.

• Fit - Fit, fit, fit! Fit is absolutely everything. It is important to consider how shoes fit you above all else. If you have all the features above, but the shoes don't fit you will have a lot of problems.

If you think you have heel spurs or plantar fasciitis then you should see your local podiatrist for a full biomechanical assessment so they can see what shoes are right for you.

We treat feet from all over Sydney, particularly the Eastern Suburbs. As podiatrists in Bondi Junction, we are happy to treat anyone that comes to our Sydney clinic. Our local area includes Bondi Junction, Bondi, Bondi Beach, North Bondi, Rose Bay, Tamarama, Coogee, Randwick, Bellevue Hill, Dover Heights, Vaucluse, and Edgecliff.