3/5/2017 3:09 AM Philip Wells Bsc.

Philip Wells Bsc.

Heel pain and golf

Heel pain and golf

3/5/2017 3:09 AM

The most common foot compliant I have seen is heel pain and golfers are no different. However, heel pain is not a medical diagnosis and I often find that the cause of the pain in the golfing foot is different from other groups of patients. The most overused self-diagnosis is plantar fasciitis with heel spurs running a close second, but on examination these are rarely the diagnosis I give.

The problem:

Plantar enthesopathies, where the tendon of the Flexor hallucis muscle and the medial slip of the plantar aponeurosis attach to the heel bone and calcaneal periostosis (Severe bruised heel syndrome) are most common. In fact, these two will often be present at the same time if the heel pain has been left untreated for a long time. More serious causes of heel pain, especially around the inside of the ankle, are also often seen. The usual culprit is PTTD (Posterior tibial tendon dysfunction) as golf adds another level of stress to this muscle and tendon. With the foot being fixed on the ground when taking a shot, this muscle will often have to work much harder to support the arches of the foot and stop it collapsing. This extra load leads to tendon damage that can be significant and take months to heal.

The original cause of the problem is often not obvious, but careful questioning will usually lead to a culprit being identified. For example, a change in shoe manufacturer or even model, an increase in activity (more golf), a job change or simply a small, one off injury from climbing ladders or standing on a sharp rock will usually be responsible.

The treatment:

The treatment plan will then include custom golf orthotics, changes in footwear and exercises for the foot, legs, and hips. In extreme cases, the body needs total rest and special immobilisation boots, like those used when a fracture has occurred. These will be used to give the body a chance to start the healing process.

The take home message is to make sure you get a diagnosis as soon as possible as this will often lead to a much quicker and long term resolution so you can get back to enjoying your golf.


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