Evaluation Of Balance And Ankle Proprioception In Calcaneal Spur Patients

A calcaneal spur, also known as enthesophyte, is an abnormal bone outgrowth at the inferior part of the calcaneus, which is the most common site of bony spur occurrence. Although there is consensus that a calcaneal spur is a common cause of heel pain, approximately 20% of calcaneal spurs are asymptomatic and its pathology remains not fully understood.Ankle Joint Position Sense (JPS) refers to the ability to accurately perceive and reproduce the position of the ankle joint in space. Balance, on the other hand, encompasses the ankle joint's positional stability during both static and dynamic activities.Several investigations have demonstrated a significant association between ankle JPS and balance, indicating that individuals with better proprioceptive acuity in the ankle joint tend to exhibit superior postural stability, ). It was found that higher plantar fascia and heel fat pad stiffness and thickness are related to higher postural sway in anterior-posterior and medial-lateral directions based on the single-leg balance tests. These results suggest that the morphological and mechanical properties of plantar fascia and heel fat pad play an important role in balance performance.

Inclusion criteria

• age will range from 40-60
• both sex male and female
• unilateral calcaneal spur
• Patients with pain and inflammation at the bottom of heel, or the location where the spur is present.
• All subjects have body mass index less than 29 kg/cm2
• sharp pain like a knife in the heel when standing up in the morning
• pain may also appear at the end of the day or after spending long periods of time on the feet
• sharp pain with the first steps in the morning or after a long period of rest and dissipating when weight bearing is initiated.
• All diagnosed patients, were evaluated and confirmed radiologically by specialist doctor, by performing a standard X-ray foot profile image

Exclusion criteria

• Surgery within the last 6 months
• Sensory or motor paralysis -Received steroid injections within the last 3 months-
• discrepancy in length of the lower extremities greater than or equal to 1 cm.
• systemic disease in the last six months that may predispose to heel pain(e.g., rheumatoid arthritis and lupus). (Dudoniene V et al.,2023).
• Calcaneal spurs are associated with various medical conditions, including obesity, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, Reiter's disease, and spondylarthritis.