What is a calcar calcanei?
Heel spur (calcar calcanei) is a bony protrusion that forms on the underside of the heel bone (calcaneus), most commonly near its front part where the plantar fascia attaches — a strong tendon-like structure that supports the arch of the foot and plays a key role in absorbing load during walking, running, and standing. This protrusion is shaped like a spur or hook and can reach up to 2 cm in length.
In many cases, the heel spur is associated with inflammation of the plantar fascia (plantar fasciitis). These two conditions are closely related because the heel spur typically develops as a result of prolonged stress and irritation of the plantar fascia. When this ligament is constantly overloaded, the body responds by trying to strengthen the area by forming additional bone tissue — leading to the development of the heel spur.
However, although heel spurs and plantar fascia inflammation are connected, a heel spur does not always cause pain. In some people, it may be discovered incidentally during X-rays of the foot taken for other reasons. On the other hand, when pain occurs, it is usually described as a sharp, stabbing pain in the heel, especially during the first steps after waking up or after prolonged sitting.
Who Are the Most Commonly Affected Groups?
Calcar calcanei often occur in people who subject their feet to heavy daily loads. This includes:
People who stand for long periods: Individuals whose jobs require them to stand for extended times (e.g., salespeople, waiters, healthcare workers) are more prone to developing heel spurs. Constant pressure on the heels can cause micro-injuries in the tissues, contributing to the formation of bony protrusions.
People who walk or run a lot: Runners and athletes, especially those involved in high-impact sports like athletics, football, or basketball, often develop heel spurs due to repetitive pressure on the heels and plantar fascia.
People with biomechanical foot problems: Structural foot abnormalities such as flat feet (when the foot arch is low or absent) or high arches (when the foot arch is unusually high) can lead to uneven weight distribution and increased stress on the plantar fascia. This added strain can contribute to the development of heel spurs.
How Does Calcar Calcanei Develop?
Calcar calcanei develops as a result of prolonged stress and micro-injuries to the plantar fascia, the tissue that connects the heel bone (calcaneus) to the front part of the foot and helps maintain its arch. When the fascia is constantly overloaded, the body reacts by producing extra bone tissue to strengthen the area around the attachment of the fascia to the heel bone. This process leads to the formation of a bony protrusion shaped like a spur, which can cause pain and discomfort.
There are several key factors that contribute to the development of calcar calcanei:
Excessive physical activity and foot overload
People engaged in intense physical activities such as running, jumping, and sports involving quick changes of direction (e.g., basketball, football, tennis) are more prone to developing calcar calcanei. Constant stress on the heel and plantar fascia causes micro-injuries and inflammatory processes, which over time can result in the formation of the bony spur.
In athletes, especially those training on hard surfaces, repetitive microtraumas occur where the plantar fascia attaches to the heel bone. Without adequate recovery time, these microtraumas can lead to calcification and spur formation.
Wearing inappropriate footwear
Footwear plays a crucial role in foot health. Wearing shoes that do not provide proper support can significantly increase the risk of plantar fascia injuries and calcar calcanei.
Flat shoes without proper arch support – Shoes with thin soles and no arch support do not absorb shock during walking, creating extra pressure on the heel.
High heels – Prolonged wearing of high heels can cause shortening of the Achilles tendon and increased pressure on the heel bone, contributing to calcar calcanei.
Worn-out shoes – Using old or deformed sneakers that have lost their cushioning and support can increase the risk of plantar fascia overload and heel bone stress.
Age and body weight
As we age, the natural elasticity of the plantar fascia and the fat pad under the heel decreases, making the foot more susceptible to injury and overload. Older individuals are more prone to inflammation of tendons and ligaments, which may contribute to the development of calcar calcanei.
Additionally, overweight individuals place increased pressure on their feet with every step. Excess body weight further overloads the plantar fascia and heel bone, accelerating micro-injuries and potential formation of the bony spur.
Biomechanical foot problems
Structural abnormalities of the foot can cause uneven weight distribution and excessive stress on certain areas of the foot, increasing the risk of calcar calcanei.
Flat feet (pes planus) – People with flattened arches tend to overstretch the plantar fascia, which can cause micro-injuries and later lead to spur formation.
High arches (pes cavus) – Individuals with high arches often have poor shock absorption, leading to increased pressure on the heel and development of the bony spur.
Abnormal gait biomechanics – Walking with excessive load on the heel or the inner side of the foot can cause uneven pressure on ligaments and fascia, contributing to calcar calcanei development.
Symptoms of Calcar Calcanei
Calcar Calcanei Symptoms
A Calcar Calcanei can be present for a long time without causing symptoms, but when pain occurs, it can significantly affect quality of life. The pain is most often caused by inflammation of the plantar fascia rather than the bony spur itself. Key symptoms include:
Sharp heel pain
The pain is usually described as stabbing or feeling like a “nail in the heel.”
It is most intense during the first steps in the morning after waking up or after a long period of rest.
The pain may decrease during the day but often returns after prolonged standing, walking, or physical activity.Gradual increase in pain
Symptoms do not appear suddenly; the pain develops gradually over time.
In the early stages, the pain can be mild and occasional, but it becomes more intense and frequent as time passes.Pain after physical activity
During activities like walking or running, the pain may be mild but worsens after resting.
People who stand a lot at work or wear inadequate footwear may notice symptoms worsening by the end of the day.Tenderness and inflammation in the heel area
Swelling and redness may appear around the heel.
Touching or pressing the heel can cause discomfort and intensify the pain.Difficulty walking and changes in gait
To avoid pain, people unconsciously change the way they walk, which can cause additional problems in the knees, hips, and lower back.
Walking on tiptoes or unevenly distributing weight on the foot can cause extra tension in leg muscles.
Diagnosis of Calcar Calcanei
Diagnosis is made based on clinical examination and additional diagnostic methods when it is necessary to exclude other possible causes of heel pain.
Clinical examination and medical history
Physical examination includes palpation (pressing) of the heel to identify the exact painful area and presence of inflammation.
Mobility tests of the foot can help assess biomechanical problems that may contribute to the development of calcar calcanei.
X-ray (Radiography)
X-ray imaging is the most commonly used diagnostic method to confirm calcar calcanei.
The image can show a bony protrusion in the shape of a spur on the underside of the calcaneus.
However, the presence of calcar calcanei on the X-ray does not necessarily mean it is the cause of pain – many people have a heel spur without symptoms.
Ultrasound
Ultrasound is used to assess the condition of the plantar fascia and detect possible inflammation.
It can reveal thickening of the fascia and presence of micro-injuries.
Magnetic Resonance Imaging (MRI) – used method
This method provides a detailed view of soft tissues and can help in making an accurate diagnosis.
Treatment of Calcar Calcanei at Fizio Center In Locco
At our Fizio Center In Locco, the treatment of calcar calcanei is based on the most modern physiotherapy methods, with a special focus on Shockwave therapy, which has proven to be the most effective solution for this problem. Our goal is rapid and lasting pain relief, improved foot function, and complete recovery for our patients.
Our Treatment Methods
Shockwave Therapy – A Revolutionary Approach
At Fizio and Aesthetic Center In Locco, Shockwave therapy is the primary treatment method because it provides long-term relief and accelerates tissue regeneration.
How Does Shockwave Therapy Work?
The therapy uses high-energy acoustic waves applied to the painful area of the heel.
These waves break down micro-calcifications, improve blood circulation, and speed up the healing process.
Inflammation is reduced and pain is relieved, allowing the foot to heal naturally.
Advantages of Shockwave Therapy:
Rapid relief – Many patients feel improvement after the very first session.
No drugs or surgery – The therapy is non-invasive and does not require medications or surgical intervention.
Short treatment time – Each session lasts about 10 minutes and is performed twice a week.
High effectiveness – Based on our long experience and use of the latest Shockwave devices, we can guarantee recovery in 95% of cases.
Ultrasound Therapy:
Ultrasound waves penetrate deeply into the tissue, improving circulation and accelerating the healing process in the affected area. This therapy helps reduce inflammation, decrease pain, and speed up the absorption of scar tissue around the calcar calcanei. Additionally, ultrasound stimulates collagen regeneration and improves joint mobility, contributing to faster recovery and reduced pain during walking.
Laser Therapy:
Laser rays use light waves that penetrate deep into the tissue, enhancing circulation and stimulating the regeneration process. In cases involving calcar calcanei, laser therapy helps reduce inflammation and pain while speeding up the recovery of damaged tissues. It also contributes to reducing swelling and accelerates the absorption of calcified deposits causing discomfort, improving function and reducing pain during walking or standing.
Why Choose Fizio Center In Locco?
Professional and Experienced Team of Physiotherapists
Our therapists have extensive experience in treating foot problems.
Modern Equipment and Latest Therapy Methods
We use the newest technology to ensure the best results.
Individual Approach to Every Patient
We tailor treatments to the specific needs and conditions of each patient.
Fast and Lasting Results
Our patients return to their activities without pain or limitations.
If you are struggling with calcar calcanei and want a quick and effective solution, Fizio Center In Locco is the right place for you. Thanks to advanced methods, especially Shockwave therapy, we achieve outstanding results in treating this condition. Don’t let heel pain limit your life — contact us and start your journey to recovery!