Skip to main content
SpringerLink
Log in

Heel Spurs and Plantar Fasciitis in Runners

  • Chapter
  • First Online:
Management of Track and Field Injuries

Abstract

Plantar fasciitis is one of the most common disorders in runners and it can reduce a player’s running ability. Reliable diagnosis with the patient’s history, physical examination, and imaging is required in planning treatment. The thickness of the proximal plantar fascia is considered to reflect the pathology of plantar fasciitis, and ultrasonography can be a reliable method for the measurement of plantar fascia thickness. In runners, treatments that can degrade performance should be avoided. Most patients will respond to conservative modalities including manipulation and stretching, extracorporeal shockwave therapy, and local injection of platelet-rich plasma, which are considered as the first line treatment. When conservative treatment has failed, endoscopic partial fasciotomy is one of the options. The authors recommend endoscopic partial fasciotomy with resection of calcaneal spurs using the deep fascial approach, which enables a wider field of vision and a large working space.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Change history

  • 18 February 2022

    This book was inadvertently published with a typo in the book title: the term “injures” has been corrected to “Injuries”

References

  1. Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int. 2004;25:303–10.

    Article  PubMed  Google Scholar 

  2. Di Caprio F, Buda R, Mosca M, Calabro’ A, Giannini S. Foot and lower limb diseases in runners: assessment of risk factors. J Sports Sci Med. 2010;9:587–96.

    PubMed  PubMed Central  Google Scholar 

  3. Lopes AD, Hespanhol Júnior LC, Yeung SS, Costa LOP. What are the main running-related musculoskeletal injuries? A systematic review. Sports Med. 2012;42:891–905.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Birrer RB, Buzermanis S, DellaCorte MP, Grisalfi PJ. Biomechanics of running. Textb Run Med. New York: McGraw-Hill, Medical Publishing Division; 2001. p. 11–19.

    Google Scholar 

  5. Cavanagh PR, Lafortune MA. Ground reaction forces in distance running. J Biomech. 1980;13:397–406.

    Article  CAS  PubMed  Google Scholar 

  6. Petraglia F, Ramazzina I, Costantino C. Plantar fasciitis in athletes: diagnostic and treatment strategies. A systematic review. Muscles Ligaments Tendons J. 2017;7:107–18.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Ribeiro AP, João SMA, Dinato RC, Tessutti VD, Sacco ICN. Dynamic patterns of forces and loading rate in runners with unilateral plantar fasciitis: a cross-sectional study. PLoS One. 2015;10:e0136971.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wu C-H, Chang K-V, Mio S, Chen W-S, Wang T-G. Sonoelastography of the plantar fascia. Radiology. 2011;259:502–7.

    Article  PubMed  Google Scholar 

  9. Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003;93:234–7.

    Article  PubMed  Google Scholar 

  10. Bartold SJ. The plantar fascia as a source of pain—biomechanics, presentation and treatment. J Bodyw Mov Ther. 2004;8:214–26.

    Article  Google Scholar 

  11. De Garceau D, Dean D, Requejo SM, Thordarson DB. The association between diagnosis of plantar fasciitis and windlass test results. Foot Ankle Int. 2003;24:251–5.

    Article  PubMed  Google Scholar 

  12. McMillan AM, Landorf KB, Barrett JT, Menz HB, Bird AR. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis. J Foot Ankle Res. 2009;2:32.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Osborne HR, Breidahl WH, Allison GT. Critical differences in lateral X-rays with and without a diagnosis of plantar fasciitis. J Sci Med Sport. 2006;9:231–7.

    Article  CAS  PubMed  Google Scholar 

  14. Li J, Muehleman C. Anatomic relationship of heel spur to surrounding soft tissues: greater variability than previously reported. Clin Anat. 2007;20:950–5.

    Article  CAS  PubMed  Google Scholar 

  15. Wainwright AM, Kelly AJ, Winson IG. Calcaneal spurs and plantar fasciitis. Foot. 1995;5:123–6.

    Article  Google Scholar 

  16. Menz HB, Zammit GV, Landorf KB, Munteanu SE. Plantar calcaneal spurs in older people: longitudinal traction or vertical compression? J Foot Ankle Res. 2008;1:7.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Wearing SC, Smeathers JE, Urry SR, Hennig EM, Hills AP. The pathomechanics of plantar fasciitis. Sports Med. 2006;36:585–611.

    Article  PubMed  Google Scholar 

  18. Prichasuk S, Subhadrabandhu T. The relationship of pes planus and calcaneal spur to plantar heel pain. Clin Orthop. 1994;306:192–6.

    Google Scholar 

  19. Singh D, Angel J, Bentley G, Trevino SG. Fortnightly review. Plantar fasciitis. BMJ. 1997;315:172–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Gibbon WW, Long G. Ultrasound of the plantar aponeurosis (fascia). Skelet Radiol. 1999;28:21–6.

    Article  CAS  Google Scholar 

  21. Kumai T, Benjamin M. Heel spur formation and the subcalcaneal enthesis of the plantar fascia. J Rheumatol. 2002;29:1957–64.

    PubMed  Google Scholar 

  22. Buchbinder R. Clinical practice. Plantar fasciitis. N Engl J Med. 2004;350:2159–66.

    Article  CAS  PubMed  Google Scholar 

  23. Lutter LD. Surgical decisions in athletes’ subcalcaneal pain. Am J Sports Med. 1986;14:481–5.

    Article  CAS  PubMed  Google Scholar 

  24. Wolgin M, Cook C, Graham C, Mauldin D. Conservative treatment of plantar heel pain: long-term follow-up. Foot Ankle Int. 1994;15:97–102.

    Article  CAS  PubMed  Google Scholar 

  25. Díaz-Llopis IV, Rodríguez-Ruíz CM, Mulet-Perry S, Mondéjar-Gómez FJ, Climent-Barberá JM, Cholbi-Llobel F. Randomized controlled study of the efficacy of the injection of botulinum toxin type A versus corticosteroids in chronic plantar fasciitis: results at one and six months. Clin Rehabil. 2012;26:594–606.

    Article  PubMed  Google Scholar 

  26. Moustafa AMA, Hassanein E, Foti C. Objective assessment of corticosteroid effect in plantar fasciitis: additional utility of ultrasound. Muscles Ligaments Tendons J. 2015;5:289–96.

    Article  PubMed  Google Scholar 

  27. Akşahin E, Doğruyol D, Yüksel HY, Hapa O, Doğan O, Celebi L, et al. The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis. Arch Orthop Trauma Surg. 2012;132:781–5.

    Article  PubMed  Google Scholar 

  28. Lee TG, Ahmad TS. Intralesional autologous blood injection compared to corticosteroid injection for treatment of chronic plantar fasciitis. A prospective, randomized, controlled trial. Foot Ankle Int. 2007;28:984–90.

    Article  PubMed  Google Scholar 

  29. Rompe JD, Cacchio A, Weil L, Furia JP, Haist J, Reiners V, et al. Plantar fascia-specific stretching versus radial shock-wave therapy as initial treatment of plantar fasciopathy. J Bone Joint Surg Am. 2010;92:2514–22.

    Article  PubMed  Google Scholar 

  30. Drake M, Bittenbender C, Boyles RE. The short-term effects of treating plantar fasciitis with a temporary custom foot orthosis and stretching. J Orthop Sports Phys Ther. 2011;41:221–31.

    Article  PubMed  Google Scholar 

  31. Weil L, Glover JP, Weil LS. A new minimally invasive technique for treating plantar fasciosis using bipolar radiofrequency: a prospective analysis. Foot Ankle Spec. 2008;1:13–8.

    Article  PubMed  Google Scholar 

  32. Stratton M, McPoil TG, Cornwall MW, Patrick K. Use of low-frequency electrical stimulation for the treatment of plantar fasciitis. J Am Podiatr Med Assoc. 2009;99:481–8.

    Article  PubMed  Google Scholar 

  33. Cotchett MP, Landorf KB, Munteanu SE, Raspovic AM. Consensus for dry needling for plantar heel pain (plantar fasciitis): a modified Delphi study. Acupunct Med. 2011;29:193–202.

    Article  PubMed  Google Scholar 

  34. Abd El Salam MS, Abd Elhafz YN. Low-dye taping versus medial arch support in managing pain and pain-related disability in patients with plantar fasciitis. Foot Ankle Spec. 2011;4:86–91.

    Article  PubMed  Google Scholar 

  35. Kiritsi O, Tsitas K, Malliaropoulos N, Mikroulis G. Ultrasonographic evaluation of plantar fasciitis after low-level laser therapy: results of a double-blind, randomized, placebo-controlled trial. Lasers Med Sci. 2010;25:275–81.

    Article  PubMed  Google Scholar 

  36. Renan-Ordine R, Alburquerque-Sendín F, de Souza DPR, Cleland JA, Fernández-de-Las-Peñas C. Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: a randomized controlled trial. J Orthop Sports Phys Ther. 2011;41:43–50.

    Article  PubMed  Google Scholar 

  37. Acevedo JI, Beskin JL. Complications of plantar fascia rupture associated with corticosteroid injection. Foot Ankle Int. 1998;19:91–7.

    Article  CAS  PubMed  Google Scholar 

  38. Ohtori S, Inoue G, Mannoji C, Saisu T, Takahashi K, Mitsuhashi S, et al. Shock wave application to rat skin induces degeneration and reinnervation of sensory nerve fibres. Neurosci Lett. 2001;315:57–60.

    Article  CAS  PubMed  Google Scholar 

  39. Takahashi N, Wada Y, Ohtori S, Saisu T, Moriya H. Application of shock waves to rat skin decreases calcitonin gene-related peptide immunoreactivity in dorsal root ganglion neurons. Auton Neurosci. 2003;107:81–4.

    Article  CAS  PubMed  Google Scholar 

  40. Wang C-J, Wang F-S, Yang KD, Weng L-H, Hsu C-C, Huang C-S, et al. Shock wave therapy induces neovascularization at the tendon-bone junction. A study in rabbits. J Orthop Res. 2003;21:984–9.

    Article  PubMed  Google Scholar 

  41. Han SH, Lee JW, Guyton GP, Parks BG, Courneya J-P, Schon LC. J.Leonard Goldner award 2008. Effect of extracorporeal shock wave therapy on cultured tenocytes. Foot Ankle Int. 2009;30:93–8.

    PubMed  Google Scholar 

  42. Sun J, Gao F, Wang Y, Sun W, Jiang B, Li Z. Extracorporeal shock wave therapy is effective in treating chronic plantar fasciitis: a meta-analysis of RCTs. Medicine (Baltimore). 2017;96:e6621.

    Article  Google Scholar 

  43. Martinelli N, Marinozzi A, Carnì S, Trovato U, Bianchi A, Denaro V. Platelet-rich plasma injections for chronic plantar fasciitis. Int Orthop. 2013;37:839–42.

    Article  PubMed  Google Scholar 

  44. Ragab EMS, Othman AMA. Platelets-rich plasma for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg. 2012;132:1065–70.

    Article  PubMed  Google Scholar 

  45. Jain K, Murphy PN, Clough TM. Platelet-rich plasma versus corticosteroid injection for plantar fasciitis: a comparative study. Foot Edinb Scotl. 2015;25:235–7.

    Google Scholar 

  46. Mahindra P, Yamin M, Selhi HS, Singla S, Soni A. Chronic plantar fasciitis: effect of platelet-rich plasma, corticosteroid, and placebo. Orthopedics. 2016;39:e285–9.

    Article  PubMed  Google Scholar 

  47. Monto RR. Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis. Foot Ankle Int. 2014;35:313–8.

    Article  PubMed  Google Scholar 

  48. Hurley ET. Platelet-rich plasma versus corticosteroids for plantar fasciitis: a meta-analysis of randomized control trials. Barcelona, Spain: 19th EFORT Annual Congress; 2018 Jun.

    Google Scholar 

  49. Chahla J, Cinque ME, Piuzzi NS, Mannava S, Geeslin AG, Murray IR, et al. A call for standardization in platelet-rich plasma preparation protocols and composition reporting: a systematic review of the clinical Orthopaedic literature. J Bone Joint Surg Am. 2017;99:1769–79.

    Article  PubMed  Google Scholar 

  50. Brugh AM, Fallat LM, Savoy-Moore RT. Lateral column symptomatology following plantar fascial release: a prospective study. J Foot Ankle Surg. 2002;41:365–71.

    Article  PubMed  Google Scholar 

  51. Sharkey NA, Ferris L, Donahue SW. Biomechanical consequences of plantar fascial release or rupture during gait: part I – disruptions in longitudinal arch conformation. Foot Ankle Int. 1998;19:812–20.

    Article  CAS  PubMed  Google Scholar 

  52. Bazaz R, Ferkel RD. Results of endoscopic plantar fascia release. Foot Ankle Int. 2007;28:549–56.

    Article  PubMed  Google Scholar 

  53. Kinley S, Frascone S, Calderone D, Wertheimer SJ, Squire MA, Wiseman FA. Endoscopic plantar fasciotomy versus traditional heel spur surgery: a prospective study. J Foot Ankle Surg. 1993;32:595–603.

    CAS  PubMed  Google Scholar 

  54. Tomczak RL, Haverstock BD. A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome. J Foot Ankle Surg. 1995;34:305–11.

    Article  CAS  PubMed  Google Scholar 

  55. Brekke MK, Green DR. Retrospective analysis of minimal-incision, endoscopic, and open procedures for heel spur syndrome. J Am Podiatr Med Assoc. 1998;88:64–72.

    Article  CAS  PubMed  Google Scholar 

  56. Wander DS. A retrospective comparison of endoscopic plantar fasciotomy to open plantar fasciotomy with heel spur resection for chronic plantar fasciitis/heel spur syndrome. J Foot Ankle Surg. 1996;35:183–4.

    Article  CAS  PubMed  Google Scholar 

  57. Barrett SL, Day SV. Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: surgical technique – early clinical results. J Foot Surg. 1991;30:568–70.

    CAS  PubMed  Google Scholar 

  58. Bader L, Park K, Gu Y, O’Malley MJ. Functional outcome of endoscopic plantar fasciotomy. Foot Ankle Int. 2012;33:37–43.

    Article  PubMed  Google Scholar 

  59. Barrett SL, Day SV. Endoscopic plantar fasciotomy: two portal endoscopic surgical techniques – clinical results of 65 procedures. J Foot Ankle Surg. 1993;32:248–56.

    CAS  PubMed  Google Scholar 

  60. Barrett SL. Endoscopic plantar fasciotomy. Clin Podiatr Med Surg. 1994;11:469–81.

    CAS  PubMed  Google Scholar 

  61. Hake DH. Endoscopic plantar fasciotomy: a minimally traumatic procedure for chronic plantar fasciitis. Ochsner J. 2000;2:175–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  62. Hogan KA, Webb D, Shereff M. Endoscopic plantar fascia release. Foot Ankle Int. 2004;25:875–81.

    Article  PubMed  Google Scholar 

  63. Lundeen RO, Aziz S, Burks JB, Rose JM. Endoscopic plantar fasciotomy: a retrospective analysis of results in 53 patients. J Foot Ankle Surg. 2000;39:208–17.

    Article  CAS  PubMed  Google Scholar 

  64. Ogilvie-Harris DJ, Lobo J. Endoscopic plantar fascia release. Arthroscopy. 2000;16:290–8.

    Article  CAS  PubMed  Google Scholar 

  65. Othman AMA, Ragab EM. Endoscopic plantar fasciotomy versus extracorporeal shock wave therapy for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg. 2010;130:1343–7.

    Article  PubMed  Google Scholar 

  66. Saxena A. Uniportal endoscopic plantar fasciotomy: a prospective study on athletic patients. Foot Ankle Int. 2004;25:882–9.

    Article  PubMed  Google Scholar 

  67. El Shazly O, El Hilaly RA, Abou El Soud MM, El Sayed MNMA. Endoscopic plantar fascia release by hooked soft-tissue electrode after failed shock wave therapy. Arthroscopy. 2010;26:1241–5.

    Article  PubMed  Google Scholar 

  68. Stone PA, Davies JL. Retrospective review of endoscopic plantar fasciotomy – 1992 through 1994. J Am Podiatr Med Assoc. 1996;86:414–20.

    Article  CAS  PubMed  Google Scholar 

  69. Urovitz EP, Birk-Urovitz A, Birk-Urovitz E. Endoscopic plantar fasciotomy in the treatment of chronic heel pain. Can J Surg. 2008;51:281–3.

    PubMed  PubMed Central  Google Scholar 

  70. Reeve F, Laughlin RT, Wright DG. Endoscopic plantar fascia release: a cross-sectional anatomic study. Foot Ankle Int. 1997;18:398–401.

    Article  CAS  PubMed  Google Scholar 

  71. Komatsu F, Takao M, Innami K, Miyamoto W, Matsushita T. Endoscopic surgery for plantar fasciitis: application of a deep-fascial approach. Arthroscopy. 2011;27:1105–9.

    Article  PubMed  Google Scholar 

  72. Blanco CE, Leon HO, Guthrie TB. Endoscopic treatment of calcaneal spur syndrome: a comprehensive technique. Arthroscopy. 2001;17:517–22.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical and Research Institute for Foot and Ankle Surgery, Jujo Hospital, Chiba, Japan

    Masato Takao, Kosui Iwashita & Yasuyuki Jujo

  2. Fortius Clinic, London, UK

    Mai Katakura

  3. New York University, New York, NY, USA

    Yoshiharu Shimozono

Authors
  1. Masato Takao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kosui Iwashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yasuyuki Jujo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mai Katakura
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshiharu Shimozono
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Masato Takao .

Editor information

Editors and Affiliations

  1. Centre of Sports Traumatology, Koelliker Hospital, Torino, Italy

    Gian Luigi Canata

  2. Orthopedic Surgery, Aspire Zone, ASPETAR Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar

    Pieter D'Hooghe

  3. Orthopaedic Surgery, University of Colorado Health, Aurora, CO, USA

    Kenneth J. Hunt

  4. Department of Orthopaedic Surgery Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands

    Gino M. M. J. Kerkhoffs

  5. Orthopaedics and Traumatology Unit, University Campus Biomedico, Rome, Italy

    Umile Giuseppe Longo

Rights and permissions

Reprints and permissions

Copyright information

© 2022 ISAKOS

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Takao, M., Iwashita, K., Jujo, Y., Katakura, M., Shimozono, Y. (2022). Heel Spurs and Plantar Fasciitis in Runners. In: Canata, G.L., D'Hooghe, P., Hunt, K.J., M. M. J. Kerkhoffs, G., Longo, U.G. (eds) Management of Track and Field Injuries. Springer, Cham. https://doi.org/10.1007/978-3-030-60216-1_26

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-60216-1_26

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-60215-4

  • Online ISBN: 978-3-030-60216-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation