ORTHOSES-HEEL PAIN

SUMMARY

1. Plantar fasciitis: pain occurs at the attachment site of the fascia along the medial aspect of the heel (anteromedial calcaneus).
2. It is common in people who hyperpronate their feet, thereby placing excess stress on the medial longitudinal arch.
3. Heel spurs related to plantar fasciitis are the result of mechanical stress acting through the plantar fascia onto its origin at the calcaneus and are not the source of the pain.

MANAGEMENT
4. Application of a calcaneal bar just distal to the painful site to prevent the calcaneus from assuming full-weight bearing status or a heel-spring set on the anterior calcaneus.
5. Rocker-botom soles can be used anterior to the painful heel.

6. Custom-made orthosis with the subtalar joint in a neutral position (such as that described for pes planus) helps prevent excessive inrolling from occurring.
7. Plantar fascia night splint: prefabricated AFO placed in a few degrees of dorsiflexion, applied during sleep for passive stretching.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.