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Heel pad syndrome is a pain that occurs in the center of the heel. [1] There are many causes, but a mechanical etiology is most common: risk factors include obesity. [1] Other conditions with similar symptoms include plantar fasciitis. [1] Treatment includes rest, pain medication, and heel cups. [1] It becomes more common with age. [1]
Pronation is a normal, desirable, and necessary component of the gait cycle. [4] Pronation is the first half of the stance phase, whereas supination starts the propulsive phase as the heel begins to lift off the ground. [5] An illustration of pronation and supination of the foot from an anatomy textbook
Whereas in normal gait, the heel strikes the ground before the toes (also called heel-to-toe walking), in Parkinsonian gait, motion is characterised by flat foot strike (where the entire foot is placed on the ground at the same time) [12] or less often and in the more advanced stages of the disease by toe-to-heel walking (where the toes touch the ground before the heel).
Plantar fasciitis or plantar heel pain is a disorder of the plantar fascia, which is the connective tissue that supports the arch of the foot. [2] It results in pain in the heel and bottom of the foot that is usually most severe with the first steps of the day or following a period of rest.
They present as multiple small or large bumps characteristically on the heels and wrists. [2] Most are asymptomatic and pain is rare, although some may present with pain before the bumps are noticed. [3] They generally occur bilaterally and display a yellowish to skin-color. [3] They may feel soft or firm. [3] [4]
Middle age is the most common age of affection, females are more affected than males, and the occurrence is often bilateral. A clinical feature of this condition is pain in the back of the heel, which is more after rest. Clinical evaluation and lateral radiographs of the ankle are mostly enough to make a diagnosis of Haglund's syndrome. [2]
Studies have been performed to determine the source of the association between toe walking and cerebral palsy. One study suggests that the toe walking—sometimes called an equinus gait—associated with cerebral palsy presents with an abnormally short medial and lateral gastrocnemius and soleus—the primary muscles involved in plantarflexion.
This shows a patient's ability to judge the position of a target. Other tests that could be performed are similar in nature and include a heel to shin test in which proximal overshoot characterizes dysmetria and an inability to draw an imaginary circle with the arms or legs without any decomposition of movement. [5]