Therapy of a Haglund heel
Conservative therapy of Haglund's heel
The general conservative therapeutic measures for Haglund's heel include anything that helps to reduce the pressure on the heel.
These include:
1. Correction of malpositions of the feet (insoles)
- Heel pad with perforated insert
- Expansion and soft footbed for the heel counter
- High shoe edge
- In summer Free heel shoes
- Weight reduction
- Temporary Reduction of physical stress.
The same physical therapy measures are used as with the Treatment of the calcaneal spur to use.
The physical therapy measures include Cold and heat applications such as Ultrasound treatments.
2. An accompanying drug therapy
with NSAIDs and cortisone (e.g. Voltaren®, Ibuprofen®) in tablet form and ointment dressings can provide symptom relief.
local Narcotics infiltration and cortisone should rather not used become. Due to the immediate proximity and concern of the Achilles tendon it can be triggered by the cortisone Tendon fiber death come, which leads to a weakening of the Achilles tendon and a Achilles tendon rupture can cause.
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Athletes (joggers, soccer players, etc.) are particularly often affected by diseases of the foot. In some cases, the cause of the foot discomfort cannot be identified at first.
Therefore, the treatment of the foot (e.g. Achilles tendonitis, heel spurs, etc.) requires a lot of experience.
I focus on a wide variety of foot diseases.
The aim of every treatment is treatment without surgery with a complete recovery of performance.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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3. Shock wave therapy:
Shock wave therapy is also used successfully. Very energetic mechanical waves are directed towards the painful area. The inflammation is supposed to be transported away by the sprouting of blood vessels. At the same time, the ossification is gradually dissolved.
This Therapy of Haglund's heel with the shock wave lasts 6 weeks. The treatment is carried out in 2-3 sessions at approx. Weekly intervals.
The costs of the individual sessions add up to 50-100 euros and are not covered by the health insurance. Various studies, on the other hand, have been able to demonstrate the positive effect of shock wave therapy.
Shock wave therapy involves high-energy mechanical waves that are generated outside the human body. Through a water-filled pillow they are transferred to the body. The shock waves are then concentrated in the process of the Haglund's heel and smash so the disturbing ones Tendon calcifications. This grinds the offending heel spur into tiny particles. In addition promote the shock waves the Blood flow to the tissue and thereby healing. The advantage of this therapy is the possibility of outpatient treatment without anesthesia. The therapy takes place in 2-3 sessions with a one-week interval.
Further information can also be found under our topic: Haglund heel irradiation.
4. Physiotherapy for Haglund's heel
physiotherapy and stretching can relieve the symptoms of Haglund's heel and are among the first conservative measures that should be taken.
Strengthening and stretching the foot and calf muscles play a role in this. The foot and calf muscles are overloaded with the Haglund heel, irritation of the tissue occurs, which in turn causes pain.
The Overloading the muscles can be treated with relaxation exercises. The calf muscles are usually shortened by a Haglund heel, which can be perceived as painful.
With physical therapy and targeted massages you can loosen the shortened ligaments and tendons. In addition, special exercises to stretch the calf muscles can be performed. For example, while sitting, you can wrap a towel around your foot and hold both ends of the towel with both hands and pull it towards your body until you feel a stretch in the calf. If you do the exercise with the knee bent, the Achilles tendon stretched.
Especially in the Achilles tendon, the Haglund heel often has tendon shortenings that can be very painful. Here, too, physiotherapy is a good way to relieve acute symptoms with the help of stretching exercises.
With a simple lunge forward, for example, a Stretch of the Achilles tendon and the calf muscles can be reached when the leg of the affected side is behind. To do this, straighten the upper body and bend the front leg, the back leg is firmly on the floor and the heel is pressed down.
In everyday life, stairs are suitable for stretching the Achilles tendon by standing on the step with only your forefoot and slowly letting the affected heel hang down over the edge. If you experience pain while stretching, you should stop stretching immediately and seek advice from a physiotherapist.
As a physiotherapeutic measure, the Haglund heel is also used Muscle relaxation techniques to recommend. With the help of certain physiotherapy techniques, cold or heat applications or also relaxing medication or yoga, the stressed muscles can be loosened and the discomfort and pain caused by the Haglund heel can be alleviated.
If physiotherapy is not successful in relieving the symptoms, further measures should be taken, and possibly also one surgery be considered.
5. Irradiation
A treatment with X-rays should only be carried out on a Haglund's heel after all other measures have been tried without any improvement. If an operation on Haglund's heel is not possible or should be avoided, radiation therapy is an option.
Inflammatory soft tissue or connective tissue diseases such as:
- Haglund's heel
- Heel spur
- arthrosis
- Tennis elbow
or - benign vascular growths
can usually be treated with radiation with good results.
The foot is irradiated in an X-ray tube for a few minutes each time over a period of a few weeks. As a rule, one can assume a treatment period of five weeks, twice a week. The treatment itself only takes a few minutes and is painless.
The main aim of the irradiation is to alleviate the pain caused by the Haglund's heel. In most cases this works well, as in about 70 to 100 percent of cases the pain associated with Haglund's heel can be successfully relieved by the radiation. The disadvantage of irradiation is that X-rays damage the cells and the higher the radiation dose, the more damage can be caused to body tissue by the radiation. The radiation dose is lower than, for example, in cancer therapy, but should not be underestimated.
According to the current state of knowledge, the irradiation of a Haglund heel is associated with very few acute side effects or long-term radiation effects and is intended to improve the blood circulation and metabolism of the cells in the inflamed tissue around the Haglund heel.
In principle, because of the risks, irradiation of a Haglund's heel should only be considered if conventional therapy and the administration of painkillers have not been able to successfully alleviate the symptoms. However, it is assumed that the earlier the Haglund's heel is irradiated, the more likely the success of the treatment is, which is why the risks and benefits of the irradiation should always be weighed individually.
According to the current state of knowledge, irradiation does not eliminate the cause of the complaints, i.e. it does not lead to the disappearance or destruction of Haglund's heel. Instead, only the inflammation in the surrounding tissue and the pain that comes with it are treated.
