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Heel Spurs

Heel spurs or plantar fasciitis with reference to the tendons associated with the heel bone is one of most common conditions among athletes. It is also referred to as heel spur syndrome because of its characteristic appearance on the X ray. It is generally caused because of a bony projection under the calcaneus bone. In many cases the pain caused is self limiting. However, the damage caused to the tendons and fibrous tissue around the heel bone can cause radiating pain and extreme discomfort.

The heel bone and the muscles attached to it also known as planar fascia and the soft tissue maintain an arch. This arch drops in case of obesity, faulty running or jumping movements and also because of other factors such as barefoot activities on hard surfaces. The constant exertion of the soft tissue and the muscles associated eventually lead to injury to the respective tissue and also cause a projection which creates an inflammation and pain during contact.

Since heel spurs is associated with sport related injuries and aging, resting the inflamed heel is the first intervention. Often orthopedics recommend anti-inflammatory drugs and sometimes suggest options such as shoe inserts for cushioning and also night splints in order to keep the plantar fascia extended. The contemporary method of treatment for severe heel spurs is extra corporeal shock wave therapy.

Fasciitis Plantar

Plantar fasciitis is the tissue at the bottom of the foot and connects through the toes and the heel bone. When this tissue gets inflamed, the heel begins to pain and this condition is referred to as plantar fasciitis. The pain in the heel is at its peak when you step out of bed first thing in the morning, after a jogging session or after a game of tennis. The pain is severe early in the morning because the tissue contracts during the night and this pain might occur after long periods of standing or while getting up after sitting for a long period. The plantar fascia is called the shock absorber of the feet and supports the arch of the feet. If too much of stress is applied to that shock absorber, it gets inflamed. The major causes contributing to this condition:


Arthritis: People with arthritis tend to suffer with this condition as it causes inflammation to the tendons of the feet.

Excessive physical activity: While indulging in excessive physical activity, the heel bone and the soft tissue on the foot get stressed out too much and lead to plantar fasciitis. Too much strain can be caused while jogging, climbing stairs and walking.

Foot shape: Few people have flat feet and therefore have an odd style of walking thus causing strain to the foot due to uneven distribution of weight on each of the foot.

Ill fitting footwear: Footwear with high heels is a major contributor to feet strain and improper fitting footwear can also cause strain to the feet.


The symptoms for the above condition sets in slowly on one foot, though there are cases where in the pain sets in severely all of a sudden. The following are the most common symptoms:


  • Severe pain in the heel, as you step out of bed after waking up in the morning or after continuous standing or climbing the stairs.
  • Pain right inside the bottom of the heel.
  • Heel pain after exercising and not during exercises.
  • Very mild swelling of the heel.
  • After standing for a prolonged time, pain in the heel or pain in the heel while getting up after sitting for a long period.

In normal course home treatment is suggested for such cases; in extreme cases doctors suggest other treatments other than home treatment.


  • A splint has to be worn in the night so that it will support the tissue and help it stretch in the morning without much of a strain.
  • Exercises are suggested to strengthen the lower leg and to stretch the tissue below the heel thereby strengthening it. Athletic taping may be recommended by the physical therapist to support the heel.
  • Orthotics or shoe inserts are recommended by the doctor so that it will give ample support to the aching heel. Over-the counter inserts are also available.

Prevention of plantar fasciitis

  • Maintain ideal body weight.
  • Use proper fitting footwear and footwear that will give the right support, do not choose too high a heel or too low a heel.
  • Replace worn out athletic shoes with new ones.
  • As you wake up in the morning stretch your feet and calf muscles and then set about your normal routine.

Marfan's syndrome

Marfan's syndrome is a disorder that affects the connective tissue. The connective tissues hold the body together and provide a framework for growth and development. When a person suffers from this condition, the connective tissue fails to act as it should. Marfan syndrome affects the skeleton, nervous system, skin, lungs, eyes, heart and blood vessels. This syndrome is usually hereditary but spontaneous gene mutation in a person can also cause this condition. Marfan's syndrome can range from light to severe and can occur in many parts of the body. In severe cases this syndrome affects the cardiovascular system.

Marfan's syndrome is caused by a defect in the gene that is responsible to produce a protein that is an important component of the connective tissue. This defect leads to increase in another protein called TGFB (Transforming Growth Factor Beta) that leads to the condition.


Marfan's syndrome symptoms

Symptoms can vary from mild to moderate depending on the severity of the problem. Generally symptoms progress along with the age of the patient. Symptoms depend upon which part of the body is afflicted.

Skeleton


  • People are tall, slim and have loose joints.
  • People have long arms, fingers, legs and toes as this syndrome affects the long bones of the skeleton.
  • Person has long and narrow face.
  • Flat feet
  • Crowded teeth as the mouth is arched.
  • Curved backbone
  • Breastbone either sticks out or caves in.

Lungs

  • Lung collapse in a few cases
  • Breathing difficulties
  • Sleep apnea

Nervous system

  • Swelling of the sac around the spinal column

Skin

Eyes (ocular system)

Cardiovascular system

  • Valve malformations
  • Palpitations
  • Heart murmur
  • Aortic aneurysm
  • Aortic dilatation
  • Aortic dissection

Marfan's syndrome diagnosis

Diagnostic criteria for Marfan's syndrome are sometimes called Ghent Criteria, named after the city in Belgium where doctors decided which features to include on the list.

  • Physical examination
  • Echocardiogram
  • MRI
  • CT scan
  • Slit-lamp exam for the eyes
  • Eye pressure test
  • Blood test for genetic testing

While there is no treatment for the condition as such, treatments are aimed at the associated symptoms.

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Bibliography / Reference

Collection of Pages - Last revised Date: August 24, 2019