Heel spur - targeted relief, conscious movement

What physiotherapy and occupational therapy can do for plantar fasciitis

A stabbing pain in the heel when you take your first step in the morning or after sitting for a long time - for many people, this is the start of a long journey of suffering. The so-called heel spur, often associated with irritation of the plantar fascia, can severely restrict everyday life and movement. The good news: in most cases, heel pain can be significantly improved through targeted physiotherapy, ergonomic relief and functional occupational therapy - without any invasive measures.

What is a heel spur?

A heel spur is a bony outgrowth on the heel bone that develops where the plantar fascia or Achilles tendon attaches. In most cases, however, the problem is not the spur itself, but an irritation or inflammation of the surrounding structures, particularly the plantar fascia (→ plantar fasciitis).

Typical symptoms:

- Sharp pain under the heel - especially in the morning or after periods of rest

- Pressure pain when walking or standing

- Gradual onset, later severe restriction under stress

- Often bilateral or in combination with knee/hip problems

Important: The bony spur is usually not the cause of the pain - the decisive factor is the mechanical overloading of the surrounding fascia, muscles and tendons.

Why exercise helps instead of rest

In the past, the rule was: insoles, immobilization, relief. Today we know that targeted movement, functional strengthening and stimulus modulation are crucial for healing. The fascia needs a good mixture of relief and activation in order to regenerate.

Aim of conservative therapy:

- Reduce stimulus without going easy on yourself

- Improve pressure distribution and gait pattern

- Strengthen foot and leg muscles

- Positively influence pain perception and movement behavior

Physiotherapy - mobilize, strengthen, relieve

Physiotherapy offers effective ways of treating the mechanical causes of heel pain - through local measures and whole-body analysis.

Therapeutic focus:

- Fascia treatment and soft tissue techniques on the sole of the foot, calf muscles and Achilles tendon

- Stretching exercises for the plantar fascia, calves and back of the thigh

- Strengthening the arch of the foot and the intrinsic foot muscles

- Gait training and posture analysis

- Medical yoga for mobilization and vegetative relief

Guiding principle: Foot pain is often "done from above" - treat the pelvis, knee and gait pattern too!

Occupational therapy - taking the strain out of everyday life, adapting movement patterns

Shoes, surfaces, working positions - everyday life has an enormous influence on the development and chronification of heel pain. This is where occupational therapy comes into play: individual, everyday and solution-oriented.

Occupational therapy approaches:

- Adaptation of load times and intensities (pacing, micro-breaks)

- Analysis and optimization of everyday situations (e.g. standing times, walking barefoot, walking on hard floors)

- Advice on ergonomic aids and insoles

- Training in alternative movement patterns at home, at work and during leisure time

- Training in self-management and body awareness

Goal: Relief in everyday life - without loss of activity.

Biopsychosocial approach - understanding pain, regaining movement

At Hockenholz, we do not view heel spurs as an isolated foot problem, but rather as an expression of a complex overload reaction of the entire musculoskeletal system - often associated with unfavorable posture habits, stress or fear of movement.

Our therapeutic approach includes:

- Pain education: why pain does not equal tissue damage

- Stimulus regulation: through movement, breathing and sensorimotor strategies

- Strengthen body awareness: regain confidence in walking and standing

- Interdisciplinary collaboration: e.g. with orthopaedists, podiatristsor shoe technicians

Conclusion: heel spurs can be treated - with a functional approach and active support

A heel spur does not need to be operated on or permanently immobilized. With a well-founded, active and everyday therapy approach involving physiotherapy and occupational therapy, the irritation can be regulated, resilience restored - and confidence in your own movement regained.

Are you a therapist and want to improve your expertise in the treatment of foot complaints?
👉 Discover our training courses for functional therapy, sensorimotor training and pain regulation at:
www.hockenholz.com/weiterbildungen

Are you affected yourself?
In our practice in Berlin - or via online counseling - we will accompany you on your way to more freedom of movement, ease and stability in everyday life.