How To Reduce Fat On The Thigh? Heel spurs, for example, might develop as a result of wearing shoes that are either too tight or thinly cushioned. Plantar calcaneal bursitis is a medical condition in which there is inflammation of the plantar calcaneal [1] bursa, a spongy fluid filled sac that cushions the fascia of the heel and the calcaneus (heel bone). This mainly occur due to the anatomical changes of heel bone. Before Icon Directions Right Arrow. Individuals who are overweight or obese, as well as those who have arthritis or who have certain gait irregularities, such as overpronation, are at higher risk of developing heel bone spurs (also known as flat feet). A calcaneal spur is a calcification at the level of the heel bone which requires specific treatments. The calcaneus is the largest of the tarsal bones ( Fig. In the end, they will have an impact on other areas of your foot. Most people who have a heel spur don't need surgery. In addition to these heel spur surgical procedures, the surgeon may also decide to remove the spur itself during the operation. Exercises, custom-made orthotics, anti-inflammatory medicines, and cortisone injections are all options for treating heel spurs. When you have plantar fasciitis, you increase your chances of acquiring heel spurs in the future. Following heel spur surgery, individuals should anticipate wearing a bandage . Patients who are overweight may find that reducing extra pounds will assist in alleviating the tension placed on the afflicted foot and heel while participating in weight-bearing activities. With this procedure, the tension that created plantar fasciitis or heel spurs is eliminated. Tel: +49. In order to assist reduce pain and edema immediately following surgery, the RICE technique should be followed. PMC Baxter's Nerve Release Below the plantar fascia, and between the muscles of the foot there is a nerve called first branch of the lateral plantar nerve/Baxter's nerve (a.k.a. Some heel spurs may not manifest themselves with any symptoms at all. Surgery includes release of the retinaculum, neurolysis of the medial and lateral plantar nerves and excision of space occupying lesions. The development of a deep wound infection often requires surgery and antibiotics. Specialty. What Is Heel Spur Surgery and How Does It Work? How long does it take to recover from foot bone spur surgery? It may take as long as three months for certain individuals to achieve a full recovery after heel bone spur surgery. This procedure requires two small incisions made on either side of the heel. 1974 Dec;64(12):987-99.doi: 10.7547/87507315-64-12-987. Remodel the calcaneus and remove any sharp or rough edges. The calcaneus spur is mostly located under your heel (beneath the sole of the foot) or at the back of your heel. Heel spur - short overview The purpose of a calcaneal osteotomy is to shift the heel bone towards the inside (medial) or outside (lateral). However, if left unchecked a heel spur and its symptoms could become more serious and heel spur surgery may then be needed. Even if surgery is successful, a heel spur may reappear in the future. Calcaneal Osteotomy (Heel Bone Spur) - Yellowstone Surgery Center Calcaneal Osteotomy (Heel Bone Spur) Calcaneal osteotomies are performed to remove bone in the heel, especially bone spurs. He then detaches, or cuts, the plantar fascia ligament from the heel bone using a small knife, relieving stress and pain, and allowing new fascia tissue to develop in the space that was created. Dr. Jeffrey Ross answered. the Inferior Calcaneal Nerve). This may also decide heel spurs surgery recovery time. , only around 5 percent of people who have heel bone spurs will feel foot discomfort as a result of their condition. According to the American Academy of Orthopedic Surgeons, more than 90 percent of individuals with plantar fasciitis will recover within 10 months after beginning basic treatment methods for the condition. Disclaimer, National Library of Medicine Most likely, patients would wear a bandage over the wound for up to two weeks following heel spur surgery. You should be up and walking in approximately 6 weeks. Patients should return to using their orthotics when they are no longer uncomfortable in their shoes. However, the heel spurs surgery recovery time may vary. A 2-millimeter incision is made and the cryoprobe is used to freeze the damaged nerve under local anesthesia. Patients should be able to move more easily and take care of their everyday requirements during this period. This can in fact be seen in radiological examination (x-ray) of the foot as a protrusion and can even grow upto 1.5 cms. the skin to hold the position. The calcaneus is the heel bone. Stretching while seated can also be accomplished by utilizing supportive bands to move the tops of the feet closer to the torso. Achilles heel spur surgery recovery time might vary depending on how the treatment worked. The content is not intended to substitute A three-year post-surgical study Surgical treatment of calcaneal spurs. This condition is defined as a bone spur that protrudes from the heel as a result of a calcium deposit on the foot. Epidemiology Plantar calcaneal spurs tend to usually occur in older men and women and may be related to obesity, osteoarthritis and current or previous heel pain. You should not put weight on your foot for at least 6-8 weeks until there is sufficient healing of the fracture. 4. It is possible to have surgery done in two different ways. The development of these bony growths may cause other medical problems or circumstances in ones daily life. The requirement of cleanliness of feet is purely aesthetic and emerges from the rules of hygiene. When the pain becomes unbearable, and medicine and non-surgical methods fail to alleviate it, your doctor may prescribe surgery to relieve it. Surgery for Heel Spurs More than 90 percent of people get better with nonsurgical treatments. Medicine (Baltimore). The spur is often hook-shaped and grows in the direction of the plantar fascia. Plantar calcaneal spurs , or sometimes simply referred to as calcaneal spurs, are a commonly seen finding in radiology practice. Diagnosis of Calcaneal Heel Spur Syndrome. The .gov means its official. Heel spurs develop over time. J Am Podiatry Assoc. How long after heel spur surgery can you walk? Plantar heel pain is a common clinical condition in orthopedic practice and is observed in about 10% of the population .. Description: spiky bone outgrowth, usually at the lower, front edge of the heel bone. Compression can be achieved by the use of bandages and wraps. Last Update: October 15, 2022. . Learn how we can help. Besides inflammation and discomfort at the bottom of the foot, there are other symptoms of a foot bone spur. Heel spurs affect about 15% of people. The majority of patients may expect a few weeks of recovery time following heel bone spur surgery. This severe disease affects the strong, fibrous tissue that runs between your heel and toes and can be quite painful. During the recovery time, one needs to pay special attention not to strain the foot in any way. Treatment of these fractures may require surgery. sural nerve and the peroneal tendons are moved out of the way and the skin is held back by placing wires in key positions. A Removal of Heel Spur procedure may be performed for the following reasons: Often, the heel spurs are painless; though sometimes, they can be associated with intermittent or chronic pain, if inflammation develops at the point of spur formation. This stimulates new bone formation and an osteophyte is formed. Billings, MT 59101 In this procedure, two slits are made around the heel. Expect a lengthy recovery after calcaneus fracture surgery. Heel spurs can also be caused by the following: All the causes may affect the heel spurs surgery recovery time. Restoration of normal alignment and contour is considered the . In many cases, releasing the plantar fascia by cutting part of it will ease the tension and greatly reduce inflammation. Treating foot pain with heel spur surgery can be done in a couple of different ways. If the bone spur is large enough, however, the surgeon may decide to remove it as well. To begin, lets talk about what causes these painful spurs in the first place. Heel spurs may develop in conjunction with other diseases, such as plantar fasciitis, which will have an impact on treatment options. The site navigation utilizes arrow, enter, escape, and space bar key commands. Not all heel fractures require surgery. doi: 10.1097/MD.0000000000013687. They are also referred to as calcaneal spurs. Calcaneal heel spurs: etiology, treatment, and a new surgical approach. Heel spurs are most commonly found at the front and underneath the heel of the foot. The calcaneal tuberosity is depressed . As the plantar fascia loosen throughout the day, what is a sharp pain at first develops into more of an ache. Mainly this will be localized, main cause for the origin is stress at the heel bone calcifying the soft tissue attachments. Luckily, surgery is successful in treating pain in most cases, although there are always potential side effects that every sufferer must learn about. Foot discomfort can result from a variety of factors, the most prevalent of which are heel spurs and plantar fasciitis. Foot Ankle Clin. Your foot and ankle specialist . Heel spurs are basically just excess calcium deposits that collect on the bottom of the calcaneus, also known colloquially as the heel bone, over a long period of time. Its crucial to remember, however, that not all heel spurs will cause stiffness or pain in the affected foot. A tourniquet is used to minimize bleeding and to ensure proper visualization of critical structures that are protected during the surgery. The pointed bony outgrowth can cause immense pain in the foot region. It is possible that a noticeable protrusion will emerge where the spur has formed in the case of bigger bone spurs. Surgery may not be needed if the shape of the heel is generally in tact. Surgery can safely proceed when the skin at the surgical site at the lateral heel Your surgeon will close the skin and apply post-surgical dressings and a splint. 2012 Jun;17(2):247-58. doi: 10.1016/j.fcl.2012.02.003. Podiatry. Treatment of these fractures may require surgery. Using this method, you can reduce discomfort, enhance your walking capacity, and increase your ability to participate in everyday activities. Addressing these factors can significantly improve your chances of preventing heel spurs. However, not all individuals who have a calcaneal spur are afflicted with chronic pain . The type of treatment you are already taking may also decide the heel spurs surgery recovery time. These products are not intended to diagnose, treat, cure, or prevent any disease. Chronic progressive history of pain described as being inside the bottom of the foot where the heel meets the arch. It is possible that these symptoms will extend to the arch of your foot. There are many factors that contribute to the formation of a heel spur such as ill-fitting shoes, repetitive or excessive stress on the feet, overuse, sudden weight gain, and obesity. When clinicians see these spurs with gout, sclerosis and small erosions may accompany them.8 Spur formation can become well defined as one might see with degenerative joint disease, rheumatoid arthritis or advanced plantar fasciitis. Instead, only a portion of the ligament is detached. government site. Additionally, the surgeon may need to do additional operations on these individuals. [1] Calcaneal spurs are typically detected by x-ray examination. The heels of the foot consists of three components: 1) the heel bone; 2) a cushion of fat that acts like a thick pad; and 3 . This first exposes the spur and it is then simply filed down with a special instrument. History and mechanical control of heel spur pain. Most bony protrusions arent apparent to the naked eye because of their location. It helps pull out excess calcium from the area of a calcaneal spur, provides pain relief and reduces inflammation. Dr. Heath performs the procedures in an outpatient setting at a state of the art facility. HHS Vulnerability Disclosure, Help Patients with diabetes may be at increased risk for infection or wound healing problems. Heel spurs are frequently detected only after X-rays and other testing have been performed for another foot problem. loss of motion should be expected. and space open menus and escape closes them as well. Calcaneal spur is the growth of calcium around the ligaments and tendons of the foot, growth will be from the bone into the flesh of the foot. Bookshelf Simply putting the balls of your feet along the edge of a step while facing upwards and gently and securely lowering your heels will provide a simple calf stretch. If your bone spurs cause pain, your doctor might recommend over-the-counter pain relievers, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others). The foot remains very stiff and some permanent In this situation, you will have discomfort in the back of your heel. If they are causing pain or irritation, your surgeon may consider removing them, but he or she will make sure there is enough fracture healing before removal. That accumulate on and around the calcaneus, commonly known colloquially as the heel bone spur removal foot, over a lengthy period of time. Once in a while, a tiny bony protrusion will become evident. A surgical procedure can be more disruptive than the presence of a bone spur in many cases. Endoscopic plantar fasciotomy is the first way to eliminate pain. [2] It is a form of exostosis . You will be given a splint or cast. If nonsurgical treatment methods have failed to relieve a persons heel spur discomfort, surgical intervention may be required to ease the pain. They may also lead to corns and calluses. The 2023 edition of ICD-10-CM M77.30 became effective on October 1, 2022. They do not appear as a result of an exercise or a sporting event on their own. Like with any surgical procedure, with heel spur surgery there are risks and possible negative results that you must be aware of before entering the procedure. Even if you have considerable improvement following bone spur surgery, for example, the spurs may reappear. Treating Heel Spurs - Podiatrist Elliott Yeldham, Singapore Podiatry . A piece of the plantar fascia will be removed during a plantar fascia release operation in order to alleviate inflammation and discomfort. A calcaneal spur (heel spur) is a bony growth on the heel of the foot. If a healthcare professional recommends more specific exercises to stretch the plantar fascia, these are generally most helpful when performed first thing in the morning before engaging in strenuous activities during the day. PRE-SURGERY left Calcaneus Heel Spur, Achilles Repair Surgery 18,880 views Jun 1, 2018 PRE-SURGERY, left foot rear calcaneus heel spur, Achilles repair 120 Dislike Share Marci B 255. They may or may not be apparent to the naked eye, depending on the situation. Calcaneal spur, unspecified foot. Depending on how your heel feels, you may still need to apply cold compresses to it in order to minimize swelling and irritation. Individuals suffering from Achilles tendinopathy can benefit from physical therapy services to alleviate discomfort in the afflicted area. The incision is minimal (1cm to 1 cm) at the inside of the heel and sutures are removed after 2 weeks. Many patients who have to heel spurs also have plantar fasciitis, which is a kind of foot inflammation. They appear as bony protrusions, extending outward from the heel bone for up to half an inch. Maintaining an elevated position for the surgically treated foot (preferably above the heart) will also help to reduce edema. Pathology The removal of the heel spur by shock wave therapy is performed with intravenous sedation and local anesthesia. In our experience, the most effective heel spur surgery is the Endoscopic Plantar Fasciotomy, or EPF. Heel spur surgery comes in when non-surgical treatments fail to give enough relief. Treatment. Amongst other functions this ligament helps to support the arch of the foot. 8600 Rockville Pike M77.30 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Apple Cider Vinegar Apple cider vinegar is a great natural remedy to treat calcaneal spurs. Heel spur calcium deposits form on the underside of the heel bone. The goal of surgery is to correct the deformity so that walking becomes less painful. Calcaneal osteotomies are performed to remove bone in the heel, especially bone spurs. Here comes the surgery and heel spurs surgery recovery time. Plantarfaciitis is an inflammation of the plantarfascia that results in pain. It is also possible that no changes appear in the soft tissues or bones around the heel. Years ago heel spur surgery was common but now a rare procedure. Patients with poor blood flow may also have Your foot will be wrapped following the procedure. If conservative treatment fails to treat symptoms of heel spurs after a period of 9 to 12 months,. Calcaneal spurs can be located at the back of the heel (dorsal heel spur) or under the sole (plantar heel spur). It refers to the bone outgrowth of your heel. A majority of people get relief from nonsurgical treatments, but in some instances, calcaneal osteotomy is the best course of action. The technique of "closed" reduction and percutaneous fixation can sometimes be utilized. Endoscopic plantar fasciotomy is the first way to eliminate pain. If the issue is severe, a healthcare professional may prescribe a comprehensive physical therapy plan that includes both stretches and other heel spur exercises to alleviate pain and suffering associated with the condition. . This procedure varies enough that we need more information before providing you a price. . Your doctor may recommend that you keep your foot elevated during the day in order to speed up the healing process. Gather further insight into this condition through this article. An Achilles contracture is defined as having <10 degrees of passive ankle dorsiflexion when the knee is in 90 degrees of flexion. The Elderly individuals may have difficulty with surgical rehabilitation. There are various surgeries available for treating heel spurs but the most preferred procedure is called the endoscopic plantar fasciotomy. after surgery. The pain due to the issue can restrict your mobility. Calcaneal spurs: The spur on the plantar surface of the calcaneus is duwe to chronic traction of the plantar fascia. An additional requirement is absolute dryness of the skin on the foot. They can also develop as a result of wearing shoes that do not provide adequate support for your foot. X-ray of the heel after calcaneus fracture surgery with hardware in place. of the fracture is best made through a CT scan. Left and right arrows move across top level links and expand / close menus in sub levels. Calcaneal Spur; Posterior Calcaneal Spur: Posterior Calcaneal Spur/ Insertions Tendinopathy / Bursitis - General points: . This is a procedure for a heel spur on the back of the heel with achilles tendonitis. Foot Ankle Clin. Bone spurs in the heel place pressure on the muscles and ligaments in the foot, and they can stretch the plantar fascia. In addition, there can be damage to nerve tissue during the procedure that could cause numbing afterward in various areas around the heel. The site is secure. occur after a fall from a height or car accident. Calcaneal spur length is significantly correlated with pain and foot function index score. Calcaneal spur is also called as heel spur. Epub 2012 Apr 10. Less common variations present with pain in the retro-calcaneal area (back), medial (inside)), or lateral (outside) of the heel. Since a calcaneal spur rarely causes any pain, people suffering from this condition often ignore the symptoms. The rear heel spur is a bony protrusion that develops where the Achilles tendon connects to the bone. Up and Down arrows will open main level menus and toggle through sub tier links. If non-surgical therapies are unsuccessful, surgery will definitely work. Reasons for such injuries are usually incorrect and overloaded loads. Plantar calcaneal spurs do appear to be associated with obesity, osteoarthritis and the aging process. If so, then read this article to know everything about heel spurs. Heel spur surgery is usually only considered after conservative treatment options have been used without success. A rear (or posterior) heel spur develops as a result of excessive tension placed on the Achilles tendon. Abstract PURPOSE OF THE STUDY The plantar calcaneal spur (inferior calcar calcanei) is a frequent source of foot pain. Enter This can seriously diminish the recurrence of pain in the heel since it prevents the tissue around the heel from being damaged further by the bone fragment. Achilles heel spur surgery recovery time might vary depending on how the treatment worked. In a classic "open" procedure, your surgeon will make an incision Careers. A calcaneal osteotomy is a bone cut (osteotomy) that a surgeon makes across the heel bone (calcaneus). Your foot and ankle orthopaedic surgeon typically identifies this type of fracture after performing a physical examination and obtaining standard foot and ankle X-rays. Everyone who sustains a malaligned break of the calcaneus, particularly involving the joint, should expect to develop some arthritis despite having surgery. The spur on the retro-calcaneal region is due to t. Read More. The pain is usually around the medial tubercle at the site of attachment of the plantar fascia to the calcaneus .Although the exact cause of this pain is unknown, plantar fasciitis, calcaneal spur, calcaneal periostitis, and entrapment of the lateral plantar nerve are some . , more than 90 percent of individuals with plantar fasciitis will recover within 10 months after beginning basic treatment methods for the condition. Heel spur - short overview. Removal of the calcaneal spur with a laser with a low frequency of radiation is performed on an outpatient . In addition, cortisone heel spur injections may be beneficial in reducing discomfort and swelling. The plantar surface of the calcaneus is elevated posteriorly to form the calcaneal tuberosity. 89. Heel spurs are a typical result of repetitive stress from activities such as walking, jogging, or leaping on hard surfaces. Many people can avoid surgery by stretching the plantar fascia, using over-the-counter pain relievers, wearing orthotics, or trying injections, but a small percentage will need surgery to correct the problem. Surgery may be indicated in the rare case of Plantar Fasciitis which does not respond to conservative treatment. (406) 237-5050. The plantar fascia stimulates to recover using this non-invasive therapy method. sharing sensitive information, make sure youre on a federal A heel spur forms where the plantar fascia (the ligament along the bottom of the foot) connects to the heel bone. Bergmann, J.N. In rare cases, heel pain may persist after surgery, although in most cases pain usually diminishes after about a week. Read more about achilles heel spurs on our website: footankleinstitute.com/achilles-bone-spur/ If a normal bone grows an extra piece of bone, it is called a bone spur or osteophyte. The wires are then removed, and a plate and screws are placed. Weight Watchers Activity Points Calculator. Through these slits in the side of the heel, a small camera is inserted which allows the surgeon to see the injured area. This scenario is most familiar with the traction type injury. Regardless, it is a good idea to talk to your orthopedic surgeon to learn about each individual procedure that is available for your condition and to choose the one that is most appropriate for you based on your consultation with your doctor. Calcaneal Spur Treatment Foot problems such as heel spurs are essentially just an accumulation of excess calcium deposits. Surgical Treatment for Heel Spurs. Author American Orthopaedic Foot & Ankle Society, The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. When the pain becomes unbearable, and medicine and non-surgical methods fail to . Patients who work in physically demanding occupations that entail a lot of walking and standing should be able to return to their employment after the first month of treatment. The kind of care taken influences the extent of recovery and restoration of foot function. The average value of the shock wave in this case is higher (up to 20.6 kV), and the number of pulses reaches 2.5 thousand. Calcaneal spurs are typically detected by a radiological examination ( x-ray ). It may be severe enough to delay surgery for weeks or preclude it altogether. . For 10 to 15 minutes at a time, apply an ice pack to the affected area of your foot. Treatment often involves surgery to reconstruct the normal anatomy of the heel and restore mobility so that patients can return to normal activity. Then carefully excise the retrocalcaneal bursa from the surrounding structures. In certain cases, people suffering from lesser heel spur symptoms may be able to complete an acceptable heel spur treatment program at home, which would consist of rest, ice, compression, and elevation. Most patients have at least some residual pain despite complete healing. Heel That Pain, Heel bone spurs can be diagnosed with an X-ray foot where a bony outgrowth can be seen at the calcaneal bone near the attachment of plantar fascia. Germany . (702) 362-2622. Calcaneal spurs have also been reported to not be oriented in the direction of soft-tissue traction (horizontally) but rather orientated vertically, suggestive of a link to compressive forces (Fig. Also called a heel spur, a calcaneal spur is a bony outgrowth from the heel bone (calcaneal tuberosity). What Is the Best Way to Tell If You Have A Heel Spur? 1. Phone Icon. Through these slits in the side of the heel, a small camera is inserted which allows the surgeon to see the injured area. Surgery for calcaneal spur is considered when conservative treatment fails to provide relief. Accessibility 2900 12th Avenue North #140W & #100E The type of treatment already undergone also plays an important role in heel spurs surgery recovery time. It covers the indication, surgical approach, postoperative care, and presents the results reported at least one year after the surgery. doi: 10.1016/j.fcl.2005.04.005. Home Remedies for Calcaneal Spur 1. This treatment can be conducted as an endoscopic or open procedure, depending on your preference. The https:// ensures that you are connecting to the Both have the capacity to conduct surgical procedures if necessary. Although there is consensus that a calcaneal spur is a common cause of heel pain . In many cases, nonsurgical heel spur therapy can provide sufficient relief from bone spur discomfort without the need for surgical intervention. How to dissolve bone spurs with essential oils? In this procedure, two slits are made around the heel. According to the American Academy of Orthopedic Surgeons, only around 5 percent of people who have heel bone spurs will feel foot discomfort as a result of their condition. Some surgeons feel that this procedure is not as effective as endoscopic plantar fasciotomy, while others think that it has better results. In many situations, therapeutic treatment will entail making changes to ones way of life. However, potential risks might include, 2022 - Yellowstone Surgery Center | Website Developed, Designed and Optimized by, Language Assistance Services: Apsalooke , Nederlands English Le Franais Deutsch Italiano | Norsk Portugus Espaol Tagalog Vitnam. Your doctor should be able to remove any stitches that have been applied within the first three to seven days. One method is to target lower spurs on the bottom of the heel. Shoes that are properly fitted, heel cushions to cushion the bottom of the foot, and implants to reduce the effects of gait disorders (such as high arches or overpronation) may all be useful. . The fracture fragments are restored to the best possible position and a plate and screws hold the fragments in place. The pain may worsen, while walking, jogging, or running. difficulty healing properly. Will physical therapy help with Achilles bone spur? Heel spur surgery should be used only as a last resort after other, more conservative treatment methods have failed to produce successful results. Heel spurs bony protrusions that grow at the bottom of the heel, on the sole of the foot. The risk of complications is very low. Moreover, to restore strength, flexibility, and mobility to the damaged tendon and to minimize swelling if it is present. . While another is to target anterior spurs on the back of the heel. Moreover, the heel spurs surgery recovery time depends on the causes as well. The calcaneal spur is also known as the heel spur. There are also other heel surgeries that are performed in a slightly different way. The main function of the calcaneus is to transfer the weight of the body to the ground, as well as to serve as a lever for the muscles of the calf. Surgery can be a same-day procedure or planned with a hospital stay. The specific type, pattern, and classification Once your exact issue has been identified, your healthcare practitioner will review the many heel spur surgery choices available to you. Continue reading to discover more about these bony growths and the factors that contribute to their formation. However, it is less common than the other treatments discussed above. and transmitted securely. It is recommended that you keep your standing and walking to a minimum during this period. Calcaneal osteotomy in the treatment of adult acquired flatfoot deformity. A heel spur is a calcium deposit that creates a bony-like growth on the underside of the heel, or underneath the sole of the foot. Complications from treatments for displaced calcaneus fractures can be severe. 8.8) . Podiatrists and orthopedists are two types of medical experts that can diagnose and treat heel discomfort. 89. It is also possible to employ night splints to keep the ligaments of the foot, especially the plantar fascia, relaxed throughout the nighttime hours. In these instances, a physical therapist will design a physical treatment program that is specific to the patients needs. A heel spur forms where the plantar fasciaband of fibrous tissue stretching along the bottom of the footconnects to the heel bone. 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