Understanding the mechanism of calcaneal enthesopathy

A simplified explanation of anatomy

The plantar fascia is located on the heel and works as a shock-absorber and a foot protector. It is not elastic, but rather like a rope.  

This structure is put under tension by excessive strain from overuse (sports activities or occupational) or by incorrect foot positioning. As it is not stretchable, tension is exerted on the insertion zones (the entheses) where an inflammatory reaction occurs (pain, excessive warmth or swelling to a greater or lesser extent).

The heel reacts to give back slack to the planta fascia through the bone restructuring, this is the formation of the heel spur ! It is for this reason that this pathology is called calcaneal enthesopathy, different from plantar myoaponeurosis, which relates more to the central part of the plantar fascia. 

Furthermore, this structure is part of the same anatomical chain, which is the extension of the achilles tendon and the calf. It is therefore easy to explain that a lack of stretching or a lack of overall elasticity results in a short chain which will lead to traction of the plantar fascia and thus to the appearance of calcaneal enthesopathy.