Causes of heel spur

heelpain caused by running

Unfortunately it is often hard to indicate what has caused your heel spur or plantar fasciitis issues. Often there is a combination of causes, this differs between patients. The  main cause is usually some kind of overload or stress. The overload causes to much tension or pressure to the heel and surrounding tendons, especially the fascia under the foot. This often comes from sports like running or jumping but it can also come from an imbalance caused by bad shoes, differences in lenght of the legs or foot-deviations like flat feet. Especially the location where the fascia attaches to the heel bone is very vulnerable to stress factors like these. Mainly these stress factors build up gradually, but also  sudden impact, like jumping from a roof, can contribute to heel issues. All this can cause the attachment of the fascia to become inflamed:


heel spur detail

All heelpain causes listed:

If we try to make up a full list of possible causes for plantar fasciitis, this would be it:

  • Sports: this typically causes overload for your muschles, bones and tendons
  • Foot abnormalities like flat feet
  • Rigid muscles in the calf area
  • Bad shoes without any cushioning or a good footbed
  • Trauma: this can be landing from a high jump or stepping on a sharp stone
  • Excess weight (sometimes caused by pregnancy)
  • Old age: Especially people over 45 often have heelpain.
  • Children: they sometimes suffer from heelpain for a limited time. This is not plantar fasciitis, but actually it is  Sever Schinz disease. This is caused by sudden growth and usually disappears after 1 or 2 years.
  • Standing still for longer period's. This is why sometimes heelpain is referred to as Policeman's Heel.
  • Heelcushion atrofie: a deterioration of the soft tissues under the heel
  • Stiff muscles in the foot
  • Issues with the tibial nerve in the foot. Also called carpal tunnel syndrome or joggersfoot
  • Sometimes diabetes

Especially the first 3 issues are a frequent issue, so we will discuss them in more detail:

Overload by sports

Many sporters and especially athletes suffer from heelpain. Any activity which may cause stress and load for the feet can be an issue. Usually this is the jumping and running that we know from sports like basketball, volleyball, running, etcetera. Often badly trained people run more risks then those well-trained, so make sure you always build up your training. Another cause of overload is found with mountaineers. Walking uphill causes the foot and calf muscles to become stretched under stress and this can have a negative impact.

If you suffer from heel spur and you still want to keep in shape, it could be wise to temporarily switch to sports like swimming and cycling, as these do not put too much load on the feet.

Foot abormalities

flat hollow feet

Another major cause for plantar fasciitis is foot abnormalities. Especially flat feet and hollow feet often occurr. Both cause the foot to lean either inward or outward and this can cause abnormal stress on many area's in the foot, especially on the fascia. As a consequence, it may become irritated and inflamed.

Stiff calf muscles

In the lower leg, the fascia is connected to the calf muscles, via the achilles tendon. Any problem in this area can cause issues and injuries. Especially people with plantar fasciitis often have relatively short calf muscles, either by nature, lack of flexibility or stifness. If so, a constant strain is put on the achilles and fascia tendons. This is often the main cause for heel spur.

You can easily recognize whether you suffer from rigid calf muscles by checking the angle of the foot and ankle: if you do not manage to lift it up to an angle less then 90 degrees, you suffer from what fysiotherapists refer to as limited doral flexibility:

dorsal flex

Research via our site

In a little research study through a poll on our website, we tried to find out what patients commonly recognize as the main factor contributing to their heel ppain complaints:

Cause Percentage
Sports 26,0%
Staand beroep 18.5%
Walking and hiking 16,6%
Overweight 12,4%
Bad shoes 9,5%
Foot abnormalities 6,5%
Other 8,5%

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