Achilles Tendinitis

The Achilles tendon is the large tendon connecting the two major calf muscles to the heel bone.

This is one of the more common sites of overuse injury seen in athletes. It is an inflammation in the large tendon that attaches to the heel bone (calcaneus). It results in specific, localized pain in the back of the heel, which is aggravated by activity, especially running. It is also seen in those playing team sports, racquet sports, and in skiers. Inflammation in the bursae ("bursitis") adjacent to the tendon can cause similar symptoms. Injuries to other nearby tendons may also occur.

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Heel Spur

Heel spur is technically a "medial subcalcaneal exostosis at the inner tubercle of the os calcis" This means a protuberance of the heel bone where it attaches to the plantar fascia (see x-ray illustration).

If this finding is present with pain overlying the area of the spur, the patient is said to have "heel spur syndrome". Since the plantar fascia connects to the heel spur, it is clear why "plantar fasciitis" and "heel spur" are often used interchangeably.

Those who spend a great deal of their time on their feet are likely to develop these conditions. Being overweight can aggravate the condition. Overstress walking, running, or jumping, especially on hard surfaces, and activities such as aerobics, stair climbing, hiking, volleyball, basketball and tennis, often lead to plantar fasciitis. A heel spur is present (on x-ray) in only about half of all patients.

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Plantar Fasciitis

Plantar fasciitis and heel spur are terms that refer to conditions that are associated with pain of the heel and bottom of the foot. Many healthcare professionals use the terms interchangeably but they are not technically the same. These conditions may or may not co-exist.

"Plantar" means bottom of the foot. Fascia is a band or sheet of fibrous tissue that lies beneath the skin and separates muscles or other structures from the surrounding tissue.

The plantar fascia is a ligament like band of tissue that is found on the sole of the foot and passes from the heel bone (calcaneus) to the bases of the toes. It is a band that helps support the arch of the foot. If you pull your big toe and foot up toward your head, you will feel this band tighten. The plantar fascia serves as a bowstring to maintain the arch of the foot. This fascia must withstand a great amount of tension. It often withstands two to four times the body's weight during activity or exercise.

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