anyone ever had this. It seems to re-occur with me about every six weeks but I can’t seem to get rid of it. My doc said just take take a couple aleve’s but did not seem too concerned.
Can you be a little more specific? Was the diagnosis given to you by your family physician?
You either have achilles tendonitis or retrocalcaneal bursitis (pretty unlikely both). They are different entities and are treated differently. Either way, if recurrent, ignoring it or taking naprosyn to alleviate symptoms when you know it will recur is silly, no? Need to address the root cause of course.
he is a sports doc who said the sac had filled up with fluid. The pain is not in the achilles area but in the back of the heel area. After doing a bit of research it looks spot on. I am looking for treatment solutions. As I said earlier it happened about six weeks ago but with a bit of rest it went away now it’s back again. Any advice would be great.
Now need to be a little more specific. Acute retroachilles bursitis is often caused by simple mechanical irritation (i.e. certain heel counters in shoes or cycling). Retrocalcaneal bursitis can be cause from compression of the bursa between the achilles and back of the heel with excessive pull or tightness of the achilles. A close cousin would be insertional Achilles tendonopathy and very difficult to tell clinically from bursitis without a diagnostic ultrasound or other imaging modalities.
Either way, need to look at the more obvious/common causes: excessive shoe friction/rigid heel counter, hill running/repeats, loose or new cycling shoes, excessive pronation of the subtalar (rear) foot, tight posterior muscle group.
Me. I have it and you have described it exactly. My Doc said take ibuprofen, but that seemed to be treating the symptoms and not the source. I sought out a skilled PT. She has been great. She noted that it was only my left achillies which might indicate an imbalance.
(BTW I am completely flat footed.) She analyzed me and after noting tightness in my hip flexors and a general lack of flexibility. Turns out I have a 1/2" leg length difference and the pain is in the shorter leg. She had me do stability tests standing on an upside down Bosu ball, turns out my lower legs needed strengthening. I have daily stretching exercises and a series of strengthen exercises.
I started at 2 visits/week and I am now going once every three weeks. She filmed me running on a treadmill as well. In addition to my exercises and stretches, I have a lift in my left shoe.
Since the end of September my longest run is just under 6 miles.
Hope this helps.
Doug
Doug,
Many Thanks for your post.
Apart from flexibilty exercises is there anything else you can do? - apart from rice and no running. Did you do any other sports i.e. cycling the only reason I ask is the pain was unbearable Saturday after a run but cycled for one hour on Sunday and no pain.
I have had no issues with biking or swimming and have continued to do that. I am trying to do yoga more often as there are many positions that seem to work out the necessaary areas of my body so that I do not hurt my achillies. When I run I am trying o concentrate on shorter strides in the hopes of becoming a mid-foot striker instead of a heal striker. Thus I am trying to keep my torso over my feet. Also I have only recently tried running small hills as that was torture on my achillies before the PT.
I had the exact same thing and it didn’t go away despite the best efforts of my orthopedic doc & physical therapist. I was about to make yet another appointment with the doc when my buddy suggested I try the Strassburg Sock as a last resort. I wore it during sleep for two weeks and my heel feels normal again. It worked for me so I’d say it’s worth a try. Good luck!
I had symptoms similar to what you’re describing; never did get a professional diagnosis, but after reading what I could find on ST and elsewhere it seemed most like retrocalcaneal bursitis. Mine was only on one side, and flared up as a result of either running hills or going too hard on soft bark trails, or a combination of both… which was logical to me in that they both place extra stress on the achilles. Got to the point it was difficult to even walk without favoring that side, especially in the mornings.
My solutions were:
- got a night splint to help hold my foot @ 90* while sleeping/healing (also used both ice & heat while watching TV in bed before going to sleep)
- limited most of my running to an outdoor all-weather track, which provided the ideal combo of a little cushioning compared to pavement, but flat & firm enough not to require extra leverage pushing off;
- not just specific to the achilles/heel issue but in general with running and injury-avoidance/maintenance, I found BarryP’s gospel of trying to build weekly volume with more frequent shorter/easy runs very helpful (vs the same total mileage over fewer/longer runs); and
- although the heel didn’t really bother me much biking, I moved my cleats back (and lowered the saddle accordingly) to promote a “flatter” foot position during the pedal stroke just to be safe (less ankle flex or “reaching” with the forefoot at the bottom of the stroke).
I’d say it took about 2-3 months of nursing it back gradually before I was back to normal, which included building to my first IM later that same season. Ran the whole marathon (except for aid station breaks) without a recurrence of the heel issue, so there’s definitely hope…
Thanks for your post. Kind of cheered me up in the fact I can get over this.