• Journal of Korean Foot and Ankle Society
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• v.8 no.1
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• pp.22-25
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• 2004

Purpose: The heel fat pad has a unique structure that is important for its shock absorbing function. Loss of elasticity and change in the thickness of the heel pad have been suggested as cause of heel pain. The present study shows the relationship between the thickness of heel fat pad and age, sex, obesity and plantar heel pain. Materials and Methods: A study of heel pad thickness using plain lateral radiographs, unloaded by body weight, was carried out on 66 patients with plantar heel pain and 326 normal subjects. The population was divided into two or three groups according to their age, sex, body mass index, and the presence of symptom. We evaluated the differences in heel pad thickness between groups, and the relationship between BMI and Sex and Age was also determined, using statistically analytic method by SPSS version 10.1 program. Results: Heel pad thickness was greater in the subject over 40 years old (p<0.001), and in the overweight (p<0.001), and male heel pad was thicker than female (p<0.001). But there was no statistically significant difference for heel pad thickness between normal subject and plantar heel pain group. Conclusion: In this study, we found that there is a relationship between heel pad thickness and age, sex, and obesity. But we could not show that the difference of heel pad thickness is contributing factor to plantar heel pain. Although it could not be proved statistically, we believe that a change of heel pad thickness play a role in the development of heel pain. So we are planning to assess a relationship of heel pad elasticity and thickness and plantar heel pain again with prospective study method on the basis of the results of this study.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.9-12
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• 2005

Purpose: This study is to compare the medial longitudinal arch between heel pain group and normal painless group. Materials and Methods: Heel pain group 242 feet and normal group 140 feet were evaluated through the radiographic images of standing foot-ankle lateral view. Four radiographic indices, talo-1stmetatarsal angle (TMA), calcaneal-1st metatarsal angle (CMA), calcaneal pitch angle (CPA), and arch ratio (AR), were used as well as BMI. Results: There was no difference between heel pain group and normal group in the TMA, CMA, CPA, and AR. But in the BMI, heel pain group showed $1.7\;kg/m^2$ (p=0.0002) higher than normal group. To eliminate the sexual error, male and female were evaluated separately. Male heel pain group showed 2.9 degrees more dorsiflexion (p=0.001) in the TMA, 3.1 degrees greater (p=0.007) in the CMA, 0.01 lower (p=0.028) in the AR, and $1.0\;kg/m^2$ greater (p=0.033) in the BMI than normal male group. There were no difference in the CPA. Female heel pain group showed 3.6 degree greater (p=0.035) in the CMA, and $1.9\;kg/m^2$ greater (p=0.002) in the BMI than normal female group. But other indices demonstrated no differences. Conclusion: talo-$1^{st}$ metatarsal angle, calcaneal-$1^{st}$ metatarsal angle and arch ratio were radiographic indices related with heel pain.

• Clinical Pain
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• v.18 no.1
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• pp.31-35
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• 2019

Plantar heel pain is a common clinical problem in foot and ankle clinics. Typically, several conditions such as plantar fasciitis, fat pad atrophy, and calcaneal fracture may lead to plantar heel pain. However, subcalcaneal bursitis occurred between plantar fascia and plantar fat pad has rarely been described as a cause of plantar heel pain. To our knowledge, subcalcaneal bursitis has been reported only once, but there was no mention of preceding factors. We firstly present a case of subcalcaneal bursitis occurred after excessive walking exercise known as "Nordic walking" and successfully managed with conservative treatments that relieve impact on plantar heel.

• The Journal of Korean Physical Therapy
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• v.32 no.1
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• pp.29-33
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• 2020

Purpose: This study examined the effects of the weight-bearing pattern and calcaneal taping on the heel width and plantar pressure in standing. Methods: Fifteen healthy subjects with normal feet participated in this study. The heel width was measured using a digital caliper, and a pedoscan was used to measure the plantar pressure of the rear foot while standing. The participants were instructed to stand in three weight-bearing patterns (anterior, middle, and posterior weight bearing) before and after calcaneal taping. The heel width and plantar pressure were measured three times before and three times after calcaneal taping, with the three weight-bearing patterns applied in random order. A 2 (non-taping vs. taping) × 3 (anterior, middle, posterior weight bearing) two-way repeated ANOVA with a Bonferroni post hoc correction was used to assess the differences in heel width and plantar pressure. Results: The results revealed a significant main effect of the weight-bearing pattern (p<.01), but not of calcaneal taping (p>.05). Greater weight bearing applied to the heel resulted in a significantly increased heel width and planter pressure of the rear foot (p<.01). Conclusion: In standing, a posterior weight-bearing pattern increases the heel width due to side-to-side shifting of the plantar heel pad, which increases the heel plantar pressure. Therefore, to prevent high stress on the heel pad and plantar heel pain, it is important to refrain from posterior weight bearing while standing during the activities of daily living.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.236-239
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• 2009

Heel abscesses present as heel pain that progressively worsens, with associated tenderness and fullness a the heel pad. To our knowledge, there are fews reports in the literature describing a spontaneous heel pad abscess. A 48-years old woman presented spontaneously with pain, erythema, edema and increased warmth to this right foot. She has no underlying disease and steroid injection history. A radiologic examination was suggestive of an abscess. Follow incision and drainage, cultures that were taken during the surgical procedure did not produce any organism. The patient was discharged home and recovered from the abscess without recurrence or further surgical intervention.

• Clinical Pain
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• v.18 no.2
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• pp.102-106
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• 2019

Tuberculosis in the foot progresses gradually; thus, diagnosis is usually delayed, and early treatment is rarely provided. If osteomyelitis occurs due to delayed diagnosis and treatment, surgical treatment should be considered. We report the case of a 46-year-old man with osteomyelitis of the calcaneus who was diagnosed with multidrug-resistant pulmonary tuberculosis and he was treated with anti-tuberculosis drugs. Bilateral adrenal masses, abscess of both testes and a small wound in the left plantar heel were observed. Both adrenal masses and abscess were regarded as paradoxical reaction of anti-tuberculosis treatment. After 1 month, he developed a pain in the left plantar heel that was compatible with calcaneal osteomyelitis in radiological features. He underwent right orchiectomy for right scrotal abscess aggravation and surgical treatment for left calcaneal osteomyelitis. Mycobacterium tuberculosis was confirmed by polymerase chain reaction. The patient was immobilized by cast for 8 weeks and the heel pain gradually improved.

• Journal of Korean Academy of Nursing
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• v.36 no.6
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• pp.992-1001
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• 2006

Purpose: This study was done to provide data for a nursing intervention to alleviate newborn pain clinically by investigating the effect of oral glucose. Methods: Subjects were newborns hospitalized in the nursery. Informed consent was obtained from parents of 60 newborns. A heel stick was carried out for a test on 3 groups; the experimental, placebo, and control group. The Neonatal infant pain scale(NIPS), respiration rate, heart rate, peripheral oxygen partial pressure($SpO_2$), and crying duration were measured to assess pain reaction. All neonatal behaviors were recorded on videotape. Results: There were significant differences in pain behavior during stimulus(F=4.195, p=.020), pain behavior immediately after blood-sampling (F=4.114, p=.021), and pain behavior 3 minutes after that (F=3.630, p=.033). However, there were no significant differences in heart rate, respiration rate, peripheral oxygen partial pressure or crying duration after the heel stick among the groups. Conclusions: Oral administration of glucose before a heel stick caused the reduction of neonatal pain behavior, which means that it has an effect of pain relief.

• International Journal of Contents
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• v.6 no.1
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• pp.41-46
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• 2010

The aim of this study was to investigate the effect of different shoe-heel heights on the surface electromyographic (EMG) activity of vastus medialis (VM) and vastus lateralis (VL) during treadmill walking in female patients with patellofemoral pain (PFP). Nineteen women with PFP participated in this research. EMG signals were recorded from the VM and VL of both sides and were compared during the treadmill walking. The subjects walked on a treadmill wearing shoes of three different heel heights: 1 cm, 3 cm and 7 cm. Each subject walked on a treadmill for five minutes at a speed of 2 km/hour with three minutes resting intervals between consecutive trials. The data were analyzed by one-way repeated-measures analysis of variance. The results of the present study indicate that EMG data of the VM and VL of female patients with PFP did improve with an increase in the height of the shoe heel, which were statistically significant. Additionally, the EMG activity of VM increased more dramatically than that of VL associated with the task of walking with high-heeled shoes on the treadmill. This study suggests that the type of high-heeled shoes is related to the VM and VL muscle activation patterns contributing to knee joint pathologies in female patients with PFP.

• Journal of the Ergonomics Society of Korea
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• v.16 no.3
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• pp.37-48
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• 1997

It is very common for women wear shoes with a high heel. It has been known that the high heel could disfigure the foot shape and cause various joint problems including back pain. However, few quantitative studies have been conducted. Therefore, in this study, the low back muscle has been investigated in order to find fatifue effect due to different heights of the heel. In particular, 0, 4, 6 and 8cm heel and two different shapes of heel have been used for an experiment. Ten healthy female subjects volunteered for the study. Isometric Trunk Exertion Frame(ITEF) and Electromyography were used to measure tha Median Frequency via Spectral analysis. The results indicated that the heel height significantly affected the local muscle fatigue of the back. After post hoc analysis, it was found that a proper heel height ougth to be lower than 5cm not to have severely fatigued back muscle after a casual walk for an hour. Such results could be applies to female industrial workers in order to prevent a cumulative trauma disorder of the back, and also to design a female dress shoes minimizing low back fatigue.

• Journal of the Korean Data and Information Science Society
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• v.27 no.1
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• pp.203-215
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• 2016

This study was performed in order to investigate the effect of breast milk on pain relief in newborn during heel lancing. Nonequivalent control group pretest-posttest design by double blinded experiment was used. 50 neonates were randomized to receive breast milk (experimental group, n=25) or no treatment (control group, n=25) before undergoing heel lancing. Informed consent was obtained from parents of 50 neonates. Neonatal infant pain scale (NIPS), respiration rate, heart rate, oxygen saturation, and crying duration were used to assess subjects' pain reaction. Data were analyzed using SPSS 18.0. The experimental and control group showed a statistically significant differences in NIPS score (F=28.89, p<.001), heart rate (F=14.03, p<.001), respiration rate (F=4.79, p=.001), oxygen saturation (F=2.69, p=.027), and crying duration (t=-8.78, p <.001) at each time points (during heel lancing, right after heel lancing, 1, 2, 3 minutes after heel lancing). The result suggest that oral administration of expressed breast milk is safe and natural agents for reducing procedural pain of neonates. Another clinical trial study with more samples is recommended.