SOME MEDICAL FACTS

Description Plantar Fasciitis & Heel Spur:

Plantar Fasciitis is an inflammation of or a tear at the point of contact of one or more of three thick bands of muscle and tendon tissue (plantar fascia) that run across the bottom of your foot and connects your heel bone to the forefoot and toes.  The “Plantar Fascia” in conjunction with the “Flexor Digitorum Brevis” anchor your heel, and toes. This layered web of muscle and tendons in each foot act as a spring during each step. As your weight is transferred from your heel to the ball of your foot the web stretches and then rebounds.  This assists your foot to toe off giving you forward motion.

Heel Spurs are the second and the more painful stage of Plantar Fasciitis.  Heel Spurs are formed as a direct result of the body trying to heal itself.  A heel spur is a build up of deposits of calcium at the points on the heel bone where the Plantar Fascia have torn or partially detached and become inflamed. The pointy deposits of calcium are like nails tearing at the muscle and tendon at the attachment point.  The pain can be and is most often agonizing and debilitating.  Your first steps in the morning can force you to wince in pain and limp to your bathroom.  The onset of pain is gradual and grows in intensity over a period of time.

Cause:

Heel spurs occur when calcium deposits build up on the underside of the heel bone, a process that usually occurs over a period of many months. Heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, inflammation of the plantar fascia, and repeated tearing of the membrane that covers the heel bone; heel spurs are “most” often associated with Plantar Fasciitis.  Inflammation caused by Plantar Fasciitis can cause calcium to deposit on the heel bone at the connection point of the plantar fascia ligaments. Heel spurs are especially common among athletes whose activities include large amounts of running and jumping.

Risk factors for heel spurs include:

  • Walking gait abnormalities,which place excessive stress on the heel bone, ligaments, and nerves near the heel
  • Running or jogging, especially on hard surfaces
  • Poorly fitted or badly worn shoes, especially those lacking appropriate arch support
  • Excess weight and obesity

Other risk factors associated with plantar fasciitis include:

  • Increasing age, which decreases plantar fascia flexibility and thins the heel’s protective fat pad
  • Diabetes
  • Spending most of the day on one’s feet
  • Frequent short bursts of physical activity
  • Having either flat feet or high arches

Symptoms:

Heel spurs often cause no symptoms. But heel spurs can be associated with intermittent or chronic pain — especially when standing first thing in the morning, while walking, jogging, or running — if inflammation develops at the point of the spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it called Plantar Fasciitis. Many people describe the pain of heel spurs and Plantar Fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning — a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand up after sitting for a prolonged period of time.

Diagnosis:

Heel spurs are diagnosed with ultrasound or X-ray imaging of the foot to identify the bony prominence (spur) of the heel bone (calcaneus). If the spur is symptomatic, identifying the underlying diagnosis such as plantar fasciitis, Achilles tendonosis, or a systemic arthritis is required in order to treat appropriately.

Pathophysiology:

The specialized soft tissue at the heel functions as a shock absorber. The subcutaneous structure consists of fibrous lamellae arranged in a complex whorl containing adipose tissues that attach with vertical fibers to the dermis and the plantar aponeurosis.

The heel can absorb 110% of the body’s weight during walking and 200% of the body’s weight during running. The plantar fascia is a multilayered fibroaponeurotic structure that arises predominantly from the medial calcaneal tuberosity and inserts distally through several slips into the plantar plates of the metatarsophalangeal joints, the flexor tendon sheaths, and the bases of the proximal phalanges of the toes.

Dorsiflexion of the toes applies traction stress at the origin of the plantar fascia. A contracture in the triceps surae, a pes cavus, or a pes planus can increase the traction load at the origin of the plantar fascia during weight bearing activities.

Other anatomic factors that can have similar effects are overpronation, discrepancy in leg length, excessive lateral tibial torsion, and excessive femoral anteversion. However, overuse, not anatomy, is the most common cause of plantar fasciitis in athletes. The pain of plantar fasciitis is caused by collagen degeneration associated with repetitive microtrauma to the plantar fascia

An inflammatory response and reparative process can double the thickness of the plantar fascia, which is normally approximately 3 mm. Biopsy specimens reveal collagen necrosis, angiofibroblastic hyperplasia, chondroid metaplasia, and calcification.

The heel pain can also have a neurologic basis. The tibial nerve, with nerve roots from L4-5 and S2-4, courses in the medial aspect of the hindfoot, through the tarsal tunnel, under the flexor retinaculum, and over the medial surface of the calcaneus. The calcaneal branch, arising directly from the tibial nerve, carries sensation from the medial and plantar heel dermis.

The tibial nerve divides into lateral and medial plantar nerves, which proceed into the plantar aspect of the foot through a foramen within the origin of the abductor hallucis muscles, which forms the distal tarsal tunnel. The first branch of the lateral plantar nerve changes course from a vertical to a horizontal direction around the medial plantar heel. It passes deep to the abductor hallucis muscle fascia and the plantar fascia and is the nerve supply to the abductor digiti minimi. The tibial nerve and its branches in the hindfoot can be involved with compressive neuropathies. A valgus heel can stretch in the tibial nerve.

YOUR OPTIONS

Guaranteed Solution

A 2ft custom made Orthotic puts an end to your foot pain caused by this painful condition. Our promise is; no drugs, no pricey consultation fees, no more pain and its backed by the 2ft 100% Money Back & Satisfaction Guarantee. 

Your custom made 2ft Orthotic supports all three of your foot arches not just one.  It is designed to realign the ankle joint so the centers of gravity correctly transfer the compression forces of your body down to the ground correctly.  This ensures that your standing stance and walking gait normalize and work as designed.  The inbuilt torsion & compression bars take the strain off of the Plantar Fascia and assist in putting a spring back intro your every step making it easier to walk and run.  Our Orthotic is a marvel of engineering and it can significantly change your life.  Try it on and you will never look back.

COST

NO MORE PAIN

VISITS

OFF WORK

SG$ 390.00

10 Days

2 VISITS

0 DAYS

Ultrasonic micro debridement:

Ultrasonic micro debridement:

While ultrasound therapy is a great treatment method to relieve heel pain, it is not a permanent solution. Regular treatments are often necessary to prevent the heel pain from reappearing. For many people, ultrasound therapy is an effective form of treatment for heel pain. It sends sound waves to the injured, painful area. These waves move at a frequency of one million vibrations per second. They can penetrate over 2 inches into the body providing the targeted relief you are looking for.

Main Disadvantage

While ultrasound therapy is a great treatment method to relieve heel pain, it is not a permanent solution. Regular treatments are often necessary to prevent the heel pain from reappearing.

COST

NO MORE PAIN

VISITS

OFF WORK

SGD $200.00 to $300.00
PER VISIT

5 to 10 DAYS

1 to 3 VISITS
PAIN WILL RETURN

1 DAY

Prolotherapy Injections:

Prolotherapy Injections:

Prolotherapy or proliferative therapy is an injection-based treatment for chronic  ligamentous injury, tendinopathy, or joint pain. The treatment causes ligament tissues to grow at and increased rate.  Animal models suggest prolotherapy may enlarge and strengthen ligament and tendon insertions, although the mechanism is unclear . Prolotherapy injection
protocols were pioneered in the 1950s by George Hackett, MD, a general surgeon in the US.
Although there are multiple theories on the mechanism of prolotherapy, the dominant theory suggests dextrose acts as a biologically inactive inflammatory substance, which stimulates tissue repair. The injection of an inflammatory solution briefly stimulates the inflammatory cascade to simulate an acute injury without deforming tissue The inflammatory cascade at the site of injection induces fibroblast proliferation and subsequent collagen synthesis, resulting in a tighter and stronger ligament or tendon.

COST

NO MORE PAIN

VISITS

OFF WORK

SGD $300.00 to $500.00
PER VISIT

3 to 15 DAYS

2 to 4 VISITS

0 DAYS

Surgery: "Not Recommended"

Invasive Surgery
Infrequently, surgery is performed on chronically inflamed spurs. More recent treatments include radio frequency ablation, injections of platelet rich plasma (PRP), extra-corporal shock wave therapy (ESWT), prolotherapy injection, and ultrasonic micro debridement.

COST

NO MORE PAIN

VISITS

OFF WORK

SGD $3,000.00 +

6 TO 10 WEEKS

6 TO 8
PRE & POST SURGERY

4 TO 6 WEEKS

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3D Tour of Human Foot: Medical Students Resources

Bio Human 3D Model

Click on the image to the right to see a 3d Bio Human model of the Anatomy and Physiology of your foot.  By selecting any component of the anatomy of this model of your foot you can view it on its own.  You can turn the model 360 degrees, zoom in and out and strip away parts to reveal the functions of the foot.  This is a medical tool and is used by doctors and surgeons world wide and accurately depicts the physiology of the human foot in detail.

Basic Instructions:

Select the “click to interact in 3d” to manipulate the model.  Select any anatomical component using your mouse pointer.  The Anatomical component will change colour.  Go to the menu that appears on your screen where you can the select different menu items that allow you to manipulate the model.   Note: Edit items in the menu allow you to isolate parts, dissect parts and cross section parts of the foot anatomy

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