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Achilles pain with plantarflexion?

 

   


Mad Jee

Dec 5, 10 7:18

Post #1 of 12 (7144 views)
Achilles pain with plantarflexion? Quote | Reply

I've had some tenderness in my achilles tendon lately. Doesn't hurt at all when I stretch the tendon by pulling my toes up towards my shin. A bit tender as I stand up on my toes and slightly worse when standing on my toes at full extension.

Not really bothersome when running, but worried about aggravating it. What hurts the worst is if I pull my foot up behind my butt as when stretching your quads, it's not an overly-stretched type of pain, as it would seem the tendon is actually shortened as I pull my toes and the bottom of my foot towards my butt, but the tendon hurts bad when doing that.

Any ideas? Thanks.



Portside Athletics Blog


rroof

Dec 5, 10 7:52

Post #2 of 12 (7138 views)
Re: Achilles pain with plantarflexion? [SwBkRn44] [In reply to] Quote | Reply

Is your achilles tender when you squeeze it from the sides with your index finger and thumb? Tender with running the thumb up/down with pressure? Occasionally, achilles paratendinitis will begin to manifest this way and is common in distance runners. It generally does progress to being tender with running though.

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD


Mad Jee

Dec 5, 10 8:09

Post #3 of 12 (7132 views)
Re: Achilles pain with plantarflexion? [rroof] [In reply to] Quote | Reply

Is your achilles tender when you squeeze it from the sides with your index finger and thumb?

No more so than the other side.

Tender with running the thumb up/down with pressure?

Not at all.

As I said, mildly tender when at full extension up on my toes. But I first really noticed it when stretching my quads, where the heel sort of pinches with the back of the leg, maybe 2-3 inches of from the bottom of the heel. It's an odd pain for a tendon, no sense of strain or over-stretching.



Portside Athletics Blog


Mad Jee

Dec 5, 10 15:23

Post #4 of 12 (7062 views)
Re: Achilles pain with plantarflexion? [SwBkRn44] [In reply to] Quote | Reply

Anyone ever experience anything similar? Any achilles tenderness I've had in the past is felt when pulling the toes up and stretching the tendon, this is just the opposite. Tenderness when pressing the toes down, even just when sitting on the couch and not pressing any weight upwards.



Portside Athletics Blog


rroof

Dec 5, 10 15:45

Post #5 of 12 (7057 views)
Re: Achilles pain with plantarflexion? [SwBkRn44] [In reply to] Quote | Reply

Again, if no pain to palpation or "use" of the achilles, then that is good. If only some tenderness with plantarflexion, need to look at posterior ankle joint issues (i.e. os trigonum syndrome, etc.)

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD


Mad Jee

Dec 5, 10 15:55

Post #6 of 12 (7046 views)
Re: Achilles pain with plantarflexion? [rroof] [In reply to] Quote | Reply

Thanks. I'll lay off it for a few days and then reassess. Obviously following the "if it hurts don't do it" rule.

I am assuming if cycling doesn't hurt I can do it. And icing the area probably can't hurt. Anything "active" I should do for recovery, ie., stretching the achilles, eccentric calf motions?



Portside Athletics Blog


rroof

Dec 5, 10 16:02

Post #7 of 12 (7042 views)
Re: Achilles pain with plantarflexion? [SwBkRn44] [In reply to] Quote | Reply

Hard to say since you don't really have a diagnosis! Having said that disclaimer: It sounds like you have experienced some achilles issues in the past and this is different. Did you google "os trigonum syndrome"? Might give you some information, but yes, you can "run through" it. Posterior stretching won't help a bit if an os trigonum, but icing will.

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD


Mad Jee

Dec 5, 10 16:07

Post #8 of 12 (7039 views)
Re: Achilles pain with plantarflexion? [rroof] [In reply to] Quote | Reply

Maybe I'll give that doc here in Boston you previously recommended a call.

I did google that trig syndrome, sounds similar to what I am experiencing. I am encouraged that it's not showing classic signs of achilles tendonitis, but a bit perplexed/worried about some weird "syndrome" involving extra bones. For now I'll quit doing quad stretches that bother my achilles :-)

I'll ice it and give it a few days. From there I'll see how it's feeling and maybe give that doc a call (if this would be within her field of speciality).



Portside Athletics Blog


rroof

Dec 5, 10 16:38

Post #9 of 12 (7030 views)
Re: Achilles pain with plantarflexion? [SwBkRn44] [In reply to] Quote | Reply

Yeah, she can handle that. There really isn't much to do, other than get some plain film X-rays (sometimes under stress plantarflexion) to confirm. Most have had the accessory bone (os trigonum) their entire life, just certain activities "irritated" it (esp extreme ankle plantarflexion, like in ballet). Rarely is it ever removed unless it interferes with your chosen activity.

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD


Mad Jee

Dec 5, 10 16:42

Post #10 of 12 (7025 views)
Re: Achilles pain with plantarflexion? [rroof] [In reply to] Quote | Reply

Damn offseason ballet training...

If it's something like trig. syndrome, I can deal with that, have a cyst behind my knee that I've learned to live with and know what irritates it and what doesn't. I'll give her a call in the morning and try to make an appt. just to get a professional opinion...in person :-)

Thanks, as always.



Portside Athletics Blog


anubis56

Jan 4, 14 18:01

Post #11 of 12 (2415 views)
Re: Achilles pain with plantarflexion? [Mad Jee] [In reply to] Quote | Reply

I think you might have posterior ankle impingement syndrome or PAIS


mdspinedoc

Jan 5, 14 17:17

Post #12 of 12 (2305 views)
Re: Achilles pain with plantarflexion? [Mad Jee] [In reply to] Quote | Reply

I have developed the same issue.. (from the rough symptoms you relate) I am in the field.. and work with PTs and MDs all day long... its a common thing to develop.. and the comments are spot on so far... Perhaps look at mid foot pronation though... often it can manifest with these sx for various reasons...

google contract-relax and perhaps apply that thought.. If I stretch, I keep all issues at bay... if not, it hurts.

PM me any time - I'm here to help.. and would be happy to have one of our radiologists do a curb-side over-read of any film you have for a second opinion...

   
 
 
 



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