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Fersensporn und Plantarsehnenreizung

Anatomie-Fersensporn-Plantarfaszie-bewegungsanalyse-hamburg

In den letzten Tagen haben wir viele Anfragen zum Thema Fersenporn erhalten. Auch in den ersten Bewegungsanalysen im neuen Jahr ging es häufig um die Ursachenforschung zur Entstehung des lästigen Fersensporns (im Volks- und Läufermund auch gern als “Sporni” bezeichnet). “Der Fersensporn kommt selten allein” … aus diesem Grund müssen wir in diesem Artikel auch die Plantarfaszie mit einbeziehen.

Anatomie

Die Plantarfaszie ist eine Sehnenplatte, die den Längsbogen des Fußgewölbes verspannt. Sie bietet damit Schutz für die Weichteile des Fußes. Dabei hat sie ihren Ursprung am Fersenbein (Calcaneus) und setzt in den Bändern an, welche am Zehen befestigt sind.

Anatomie-Fersensporn-Plantarfaszie-bewegungsanalyse-hamburg

© Kriwat – Der Fussspezialist

Symptome

Belastungsabhängig kommt es zu Schmerzen im Bereich der Ferse und des Längsgewölbes. Beim Zehen- und Hackengang zeigt sich eine Schmerzverstärkung. Betroffene klagen über Druckschmerzen und es existiert eine morgendliche Gewebesteife.

Oftmals klagen Patienten über ein Taubheitsgefühl an der Außenseite der Fußsohle. Häufig verursacht der Bergauflauf Schmerzen. Eine massive Überlastung der Plantarfaszie führt zur Ausbildung eines Fersensporns.

Ursache

Die häufigsten Ursachen sind Fußfehlstellungen (Überpronation, Senk-/Spreizfüsse, Hohlfüsse), falsches Schuhwerk mit mangelhafter Unterstützung des Längsgewölbes, Überlastungen sowie Trainingsfehler (zu harter Untergrund, übermäßige Bergaufläufe). Hierdurch kommt es bei Belastungen zu starkem Zug auf die Faszie, welche passiv das Gewölbe aufspannt. Auf Grund der Zugbeanspruchung kann es zum Knochenabbau an der Faszieninsertion am Fersenbein (Calcaneus) kommen und es kommt zur Ausbildung eines Fersensporns.

Diagnose

Es lässt sich ein druckschmerzhafter Punkt am zehenwärts gerichteten Ansatz der Plantarsehne am Fersenbein und im Bereich der Plantarsehne tasten. Mitunter zeigt die Röntgenaufnahme eine Calciumanreicherung am Sehnenansatz. In vielen Fällen ist das Röntgenbild jedoch nicht auffällig.

Therapie

Die Therapie beinhaltet im akuten Stadium das Pausieren und Kühlen. Es empfiehlt sich zudem entlastende Einlagen mit Fersenspornpolstung und ggf mit einer Plantarsehnenaussparung zu tragen. Dehnungsübungen sollten durchgeführt werden.

Bewegungsanalyse

In der Bewegungsanalyse wird zunächst auf Druckschmerzhaftigkeit im Bereich der Ferse (Fersensporn) und im Bereich der Plantarfaszie untersucht. Besonderes Augenmerk liegt hierbei auf der Landephase und auf der Abstoßphase des Fußes in der Bewegung. Hier kommt es meist zu einer Fehlbewegung auf Grund einer Schonhaltung. Dies führt oftmals zu anderen Verletzungsmechanismen (z.B. Achillodynie).

WELCHE VERLETZUNG INTERESSIERT DICH ALS NÄCHSTES IN DER REIHE “LAUFSPEZIFISCHE VERLETZUNGEN” ?
HINTERLASSE DEINEN WUNSCH IN DEN KOMMENTAREN.

 

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