Tag Archives: heel pain

Stretching for Haglund’s deformity? What am I missing?

I really do not get this one, perhaps someone can explain it to me.

Haglund’s deformity (pump bump, retrocalcaneal exostosis, Bauer bump, etc) is an enlargement of the bone at the back of the heel that is irritated by the footwear causing a bursitis and the painful symptoms. I do not think that there is anything controversial about this and what it is.

I recently did a bit of a dive into Haglund’s as I had to write something about it. What I was surprised and perplexed as is that probably over 90% of the articles I came across on this on websites recommended that calf muscle stretching be done to help Haglund’s.

If you want to have a look, check this Google search. Look at some of the sources for the “best exercises” for Haglunds! eg WebMD, Livestrong, American College of Foot and Ankle Surgeons etc. I was prepared to give some of them the benefit of the doubt in that they may be confused between an insertional Achilles tendinopathy and the bony bump of Haglund’s, but, no, they all generally defined it as a bony bump at the back of the heel and advised stretching exercises!

Can someone please explain to me why? Why would stretching the calf muscles stop the shoe from irritating an enlarged bit of bone at the back of the heel?

I did not bother for a literature search looking for evidence on this as I know there is none.

[I suppose some could argue that if the calf muscles are tight that this might cause excessive movement of the foot/heel in the shoe and increase the rubbing on the Haglund’s deformity, but I have not seen that and even if that was a problem, it would only help if the calf muscles were tight and only after months of stretching.]

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Does calcaneal apophysitis occur in adults?

No.

Of course it doesn’t. Its a disorder of the calcaneal growth plate that can not happen after the teenager stops growing as that growth plate merges with the rest of the calcaneus and is no longer there to cause problems. So why are you writing a blog post for on does calcaneal apophysitis occur in adults? Good question, glad you asked it. Here is why:

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Cupping For Plantar Fasciitis

We all have seen those photos of swimmers at the Olympics with bruises all over their bodies and wondered, “whaaaaaaaaaat?”.

It is an alleged therapeutic technique known as cupping where the therapist places special cups on your skin to create suction to supposedly help with with pain and inflammation and as a type of deep-tissue massage.

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Platelet Rich Plasma for Plantar Fasciitis – writing about something I know nothing about…

Platelet Rich Plasma for Plantar Fasciitis

I have to be honest and admit that the use of platelet rich plasma (PRP) for plantar fasciitis is something that I have had no more than a superficial interest in. I pretty much scanned the abstracts of the studies and systematic reviews as they are published of it in this thread and the one comparing it to other interventions on Podiatry Arena. I also note comments in social media on it from those whose views I respect. From my superficial understanding, it works, it does not work, it works, it does not work … a lot of the studies that compare it to other treatments do not do the “other” treatment very well (ie wrong dosing), which can easily bias the study to PRP being better. Some of the comments in social media from people who I consider real experts, especially in the context of tendinopathy are that it does not work, yet a lot of people claim it does. Yes, I know that the “plantar fasica” is not a “tendon” and it may or may not be appropriate to translate “tendinopathy” research to “plantar fasciitis” (not that this stops people doing so or not doing so if the research on it matches their pre-conceived biases!).

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Plantar fasciitis loading programs – overhyped evidence

I have managed to get myself into a few spats in social media lately over the results of the Rathleff et al (2014) study on loading programs for plantar fasciitis mainly because I think the study is way overhyped and blindly and widely shared by too many devoid of critical thinking skills. I blogged about this study at the time on my other blog, so thought I would re-litigate the main issues here, so I can refer those in my social media spats to have a read of.

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Natural Cures for Heel Spurs – the quack is strong in this one.

The whole ‘natural cures’  industry is a scam. Just because something is natural does not make it better. Arsenic is natural. Ionizing radiation is natural. Neither of them are any good for you. Arguing that something is better because it is natural is a logical fallacy.

As for the natural cures for heel spurs in the infographic below. None of them will or can work. Its that simple. It is physiologically implausible and biologically impossible for any of them to work; let alone there being a single shred of evidence showing they work. I never cease to be amazed at those who should know better are so devoid of any critical thinking skills.

 

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