Heel spur: why it keeps coming back

Your heel hurts with the first steps out of bed, or when you get up after sitting for a while. A few paces later it eases off. Many people call this a heel spur. It feels as though you were a horse being spurred on.

For most people it settles of its own accord within a year. This article is for those in whom it lingers, or keeps coming back.

Where it hurts

A broad band of connective tissue, the plantar fascia, runs along the underside of the foot from the heel bone to the toes. With every step the foot takes your weight and springs back. That work ought to be shared across the four muscle layers of the sole. If the foot doesn't spring enough, because the arch is too high or too flat, most of the load falls on the plantar fascia. Where it attaches to the heel, it begins to hurt.

The ankle

As you walk, the ankle rolls forward. It flexes and extends, opens and closes, so that the sole of the foot alternately lengthens and shortens. Many ankles can't do this well enough. The plantar fascia is then either held on too much stretch, or it stays too short and won't give under pressure. Either way, it becomes overloaded.

The foot doesn't stand alone

How your pelvis sits and what your pelvic floor is doing both affect how much room the ankle and the sole of the foot are given. What I often see is a pelvis in posterior tilt and a lifted pelvic floor alongside high, short arches; or a pelvis in anterior tilt and a low pelvic floor alongside long, low arches. There are combinations too. In both cases, muscles meant for movement are doing the work of postural muscles.

Then there's the pain itself. The nervous system starts to avoid any stretch in the foot, and so the pain keeps the pattern going.

Training the feet alone won't break that pattern of tension. For that, your whole posture has to change.

What I do

I work with Anatomy in Motion. Together we give your head, ribcage and pelvis the chance to move enough again in all three planes, and on both sides. That's what makes it possible to change the timing and direction of your gait.

A wedge can help your nervous system along the way. It raises the ground for a while in one spot, under the heel for instance, much like a small heel under your shoe. Angled in a particular direction, it helps the heel roll more readily the way we're after. Or you find that direction sooner and need less movement to get there, because the ground is already there.

You practise on a soft, slightly springy surface that supports the sole of your foot. That's how you learn to spread the pressure more evenly, and putting weight on the foot begins to feel safer. Step by step, you allow more pressure and more stretch.

Taking it further

Would you like to explore your own gait and restore it? You can, in personal training with Anatomy in Motion. If you'd rather work in a small group, there's the Walking with Ease class. Getting to know each other is free.