2023-11-22 17:30:58
Every week, Dr Jean-Marc Sène, sports doctor, presents his sports column in Priorité Santé. Today, he talks to us about plantar aponeurysm, a pathology that is more commonly called heel spur.
Published on: 11/22/2023 – 4:30 p.m.
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What exactly is plantar fasciitis?
It is one of the most common injuries in running. Plantar aponeurosis or plantar fasciitis corresponds to an inflammation of the aponeurosis (or plantar fascia), that is to say of the fibrous membrane located on the plantar part of the foot. Its role is to support and protect the tendon of the sole of the foot and the plantar arch.
This pathology mainly develops in athletes who frequently run. It does not result from direct trauma such as a shock or twisting but from repeated, abnormal, or excessive traction on the membrane which creates micro-lesions.
It can be caused by practicing on too hard terrain, wearing shoes that are unsuitable for the sporting activity or body type, or poor running technique (downhill or on the front of the foot). These are the factors that favor its appearance, which can lead to a rupture of the plantar aponeurosis.
What are the symptoms ?
The symptoms are quite characteristic:
• Heel pain, described as feeling like there is a nail sticking through the foot, worse with weight bearing and walking. This pain causes people to walk on the ball of the foot or the outer edge of the midfoot.
• The pain is often more severe when you start walking in the morning and tends to decrease afterwards
• Sometimes tensions and contractures in the Achilles tendon and calf
If the pain is persistent and nothing is done to relieve it, it can quickly become chronic. If you experience pain and symptoms that may correspond to this specific running and trail running injury, consult a healthcare professional.
How to treat this plantar aponeurosis?
People who suffer from plantar aponeuritis must be told that the evolution is favorable in the vast majority: more than 90-95% of patients are either cured or minimally symptomatic after one year. So it’s about showing perseverance.
Treatment of plantar fasciitis is based on a number of measures:
• First of all, occasional and partial rest of the heel: cessation of activities which cause intense pain, reduction of physical activity requiring support on the ground, practice of sports to relieve stress;
• Maintaining appropriate physical activity to avoid any deconditioning despite the limitation of walking and running;
• Wearing of shock-absorbing heel pads for a limited duration;
• Weightloss
• Taking anti-inflammatories and applying ice to limit pain
At the physiotherapist:
• Stretching of the plantar aponeurosis and the entire suro-achilleo-plantar chain;
• Deep transverse massage; muscle strengthening;
• Shock waves in case of persistent pain;
• Corticosteroid injections are sometimes offered for persistent forms, but be careful there is a risk of weakening the plantar aponeurosis which could lead to its rupture.
• New features: Platelet-Rich Plasma Injection
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