I have an Achilles Bursitis issue and everyone says to “Rice” it, and all I hear is ice, ice, ice. But I went to the Dr. today and he told me to Heat it, because the blood flow to it will help it heal quicker and icing it only slows down the blood flow. Anyone know about this?? Thanks, Chad
So, how did you arrive at this diagnosis? ultrasound? MRI? Physical exam only? So, retrocalcaneal bursitis (“achilles bursitis”) or achilles tendonitis - they are different entities and are treated quite differently.
Went to the Ortho Doctor today and after he examined my foot, this is what he said it was. ( Achilles Bursitis) He wants me to go to PT for a month, for ultra sound, and exercises.
Well, that is not very helpful. But, you paid for a hands on exam and tx plan, so you would be wise (at least initially) to follow it …
Ice it, ice it more, and ice it again, 3x/day. Do some good calf stretches 1-2 times a day. Rest it for a week and then try to get back to running, slow and short at first. Then ice it again. 
I have an Achilles Bursitis issue and everyone says to “Rice” it, and all I hear is ice, ice, ice. But I went to the Dr. today and he told me to Heat it, because the blood flow to it will help it heal quicker and icing it only slows down the blood flow. Anyone know about this?? Thanks, Chad
Hi,
I don’t post much here for fear of being ripped apart, but I hope at least to help here.
I’ve just recovered (90%) from Achilles Bursitis.
Last year I did IM CH, was planning IM DE this year, and then on Honeymoon last September, in a game of football, I was tackled and my ankle was hit hard.
After a lot of painful running in October, I consulted a doctor and was sent to a Physio who deals with the German Tri team + some other known athletes e.g Timo Bracht, so I guess he knew what he was talking about.
After an XRay and Ultrasound, bursitis was diagnosed, and I was ordered to stop ALL activity asap. This included swimming, due to the fear of aggravating by pushing off the wall. You only need to overload the heel once, and the infammation comes back.
I was prescribedd 3 appointments per week for electricity/ultrasound treatment. Other than that, nothing. No heat, no ice.
I was told NEVER to wear anything but loose shoes - you MUST avoid pressure on the heel. I twice wore shoes I thought were ok, and within a day, I had caused the inflammation to return to the starting state. Please heed this warning!!! It is critical. The area is very sensitive. Another althelete (a proper one, not a fatty like me) I met at the center also had it, and had cut a slit into his shoes at the back with a pair of scissors!
I had a setback due to shoes in December, another in January, and now, after 6 months (and two pairs of smelly shoes), I can finally run again. Needless to say, IM is out the window. Running has to be done at virtual walking pace for the next four weeks, rolling from heel to toe, and then I have a treadmill test with the Physio Center to assess returning to normal training.
I’m sorry to give you bad news… but if you really have the correct diagnosis, you’re in for a bad time. It’s very sensitive, and enormously frustrating.
Summary:
Ultrasound
Rest
LOOSE SHOES
Do not risk aggravation.
Regards
Richard
In most cases, from a therapy perspective, you can cetainly treat the symptoms (ice or heat, etc) depending on your situation, but on the long term solution front, which is what therapy is for, your will need to find what is weak and strengthen it. You also need to find what is tight and loosten it. I would not just stretch what hurts (if it is unstable you cetainly dont want to do this). Your PT should help you determine what to do.
Often tendonitis and bursitis have brakes (muscle firing) that come on when they are not supposed to. Learn to shut the unnecessary brakes off – this often helps almost any soft tissue pain. This is usually not where you hurt, it is in a nearby muscle.
Static passive stretching even weakens the muscle to brain connection weaker – at least temporarily by affecting the receptors in the tendons.
Hey Richard, Thank you soon much for your post, I did IM Lake Placid last year, trained all through the winter ( even through our 100 snow storms) and I am doing IM Louisville this year, so this is not something that I want to hang around. It seems like the to things people keep saying is rest and ice, so that is what I will be doing. I did not know about the shoe issue so I will make sure on that also. Swimming seems to be no problem, and I have not done much biking yet, so you were told to do nothing? The Doctor told me to cross train, thats why I am so confused.
Thanks again for your post, and dont worry about getting ripped apart, most of the people that do that dont need to be on here any ways. Chad
Hey Chris, Thank you very much for your post, it makes total since. I do have a leg length difference and wear orthotices for that, but I have not worn them for a while, maybe I need them again? Also I was reading where the 3 things that can cause this problem is, Long runs, fast runs and hill runs, I did all three the week this happened! Thanks again for your post. Chad
As noted by rroof, there seems to be some confusion as to the diagnosis. A simple phone call to your doc’s office could clear this up. The two really are treated differently with different long term outcomes.
Thanks John, The official diagnosis is Achilles bursitis/tendonitis. This is what the PT order says: Weight bearing as tolerated, Achilles tendon stretching, analgesic modalities, increase ROM and strenth, proprioception exercises,therapeutic exercise and modalities. 1 to 2 times per week for 4 weeks. Also I was given Diclofenac Sodium 75 mg to be taken twice a day. Does any of this sound right or do I need to go see another Doctor?? Thanks, Chad
good luck getting it resolved quickly. Are you allowed to water run? bike?
I have an Achilles Bursitis issue and everyone says to “Rice” it, and all I hear is ice, ice, ice. But I went to the Dr. today and he told me to Heat it, because the blood flow to it will help it heal quicker and icing it only slows down the blood flow. Anyone know about this?? Thanks, Chad
I had the same thing. Since I am no longer interested in doing triathlons, I just quit running for a month. Cleared it right up. You know…these little nagging injuries are no big deal when you don’t have a race hanging over your head ; ).
I circulated this before. It may apply here.
http://www.clinicalsportsmedicine.com/chapters/32.pdf
Note the Painful heel drop protocol. This is what I may start following
Another thing you might try is heel lifts which gives the achilles tendon a rest.
If you try them do both shoes
Yes, my Doctor told me to do all I want as long as it dont hurt. I have been swimming the past 2 days and I have also biked with no pain.
Hey Mike, I agree some much with you, I have 2 races, in the next two weeks, so If I had none I would heal right up!!
Hey Thanks, I will give them a try.
Hey thanks for the link, that was very helpful. Chad
Ice works the same as heat only if you ice it to the point that it gets so cold the body decides to rush blood to the area to stave off frostbite. If it’s not beat red when you are done icing then you haven’t done any good.
Heat is a more comfortable way to accomplish the same thing, so do what your Dr. suggested.
The PT using ultrasound is a very good treatment option too…jump on that.