Anyone had this ? Not sure if I should
Just get operation done or see if MORE rest works. Get it done now I might have a season next year. Don’t get it done and rest does not help definetly no season. This is how doc explained it to me.
I have been in pain since Feb when I run. Went to one Dr. And PT was prescribed. Had seemed to get better but after running a bit more it was right back.
I have a peice of bone that is sandwiched between muscle /tendon and ankle heel bone. Plus tendinitis of Achilles still. No running ,rest is what I was told and not to stand on it to long. Also
Not to wear tight shoe’s. If it does not get better he said they would have to remove muscle / tendon scrape out bone pieces and also grind at top of heel where it looks like a horn. Then reattach muscle / tendon. Recovery would be 6-8 weeks in a cast and probably PT for 4-6 weeks more. To top it off pulling out of parking lot a lady rear ends me. Pushes my bumper down and snaps my tailpipe wear it meets the muffler :0(
http://i59.tinypic.com/vcrixd.jpg
Note: I’m not a Dr., just reasonably informed and experienced with similar issues.
I’m curious how you initially injured the calcaneous. Did you fall from height and land on your heel, or was this caused by overuse? That fact that it has apparently been many months since initial injury limits your options. A permanent solution will require that the fragment be removed. PT and/or cortisone won’t help. I’d seek out the best ortho surgeon you can afford. However, ask around about someone highly experienced with athletes since those doctors have a goal to get you moving again and excelling ASAP. Other surgeons will often opt for the easy fix with least chance of complications.
I am a sports physician. I want to start by saying that it is very difficult to give accurate advice with one Xray view, no chance to examine you and a limited history. But you do not have an ‘extra bone’ at all. The arrow on the Xray is pointing to an area of calcification that has developed within the tendon. The most likely diagnosis is calcific tendinopathy. Sometimes tendon injuries can heel with calcific scar tissue. The calcium can certainly make it harder to treat the tendon successfully but it rarely requires surgical debridement. Dettaching and re-attaching the tendon is a big deal that has potential complications including tendon rupture and it will take considerable rehab to get you training on it again. It is best to “treat the person not the Xray” and manage this with the normal conservative measures that are used for tendonopathy. Consideration may also bee given to extracorporeal shockwave therapy (ESWT) which is a non-invasive way of attempting to breakdown the calicific region.
Most likely injured it from overuse. The First Dr. Tried PT right away. After seeming to get better and running again ( on a boring HS track ) it actually started feeling worse then it did before. I will go for a second opinion see if I can find a Dr. who sees more of this. Doc who took this X-ray told me we only have so many miles we can run. I did not like that to much.
I am a sports physician. I want to start by saying that it is very difficult to give accurate advice with one Xray view, no chance to examine you and a limited history. But you do not have an ‘extra bone’ at all. The arrow on the Xray is pointing to an area of calcification that has developed within the tendon. The most likely diagnosis is calcific tendinopathy. Sometimes tendon injuries can heel with calcific scar tissue. The calcium can certainly make it harder to treat the tendon successfully but it rarely requires surgical debridement. Dettaching and re-attaching the tendon is a big deal that has potential complications including tendon rupture and it will take considerable rehab to get you training on it again. It is best to “treat the person not the Xray” and manage this with the normal conservative measures that are used for tendonopathy. Consideration may also bee given to extracorporeal shockwave therapy (ESWT) which is a non-invasive way of attempting to breakdown the calicific region.
Would my tems unit help knock it down?
not a doc, but I agree with what the medical dude above said.
You really dont want to have a op on the Achilles tendon unless you have no other options. Those can be a b!tch either way.
Depending where you are look for a specialist in tendinopathy. I had a friend shut down for 1 year with the same problem as you. Few months with a physio who specialised in tendinopathy and she was 100% and is now getting ready for kona.
Will do thanks everyone for the help and guidance.
Agreed with MD above. Not a sesamoid or bone fragment but more likely calcium or spur that broke off, but more likely calcific deposit within the tissue which makes it very painful. Two causes of calcific tendonopathy: degenerative or idiopathic. The idiopathic seems to be more painful but your location would result in a lot of pain regardless. I also agree, surgical intervention would lend itself to more risks and a longer rehab. The body usually resorbs the calcium over time or levage is used arthroscopically to deride and remove the deposits, kind of like using a skimmer/vacuum to stir up and suck up rocks on the bottom of a pool.
Rest is unfortunately the best option, nothing magical about it. Some studies show efficacy of ultrasound of ECSW to help break up the calcium and make it “easier” for the body to resorb it, but it is limited. Tens is purely for pain and will not be effective in facilitating healing, but may help improve comfort by overriding the pain receptors.
A second opinion is always good! Best of luck.
Most likely injured it from overuse. The First Dr. Tried PT right away. After seeming to get better and running again ( on a boring HS track ) it actually started feeling worse then it did before. I will go for a second opinion see if I can find a Dr. who sees more of this. Doc who took this X-ray told me we only have so many miles we can run. I did not like that to much.
This is exactly what I was wondering, and it points directly to what gazman has described and outlined. The fact that your doc wants to detach, scrape and reattach, and that he thinks that there’s “only so many miles we can run” speaks volumes for his limited, and very invasive way of thinking. Google and read up on “calcific tendonitis” to learn more before talking with your next physician so that you can ask more informed questions.
I don’t trust doctors that don’t run. Doctors are pretty focused on health. They clearly see day in and day out how much of a benefit running has to the body. A non running doctor is pretty similar to a doctor who smokes. Though I would trust Sherman Cottle as my doctor.
Most likely injured it from overuse. The First Dr. Tried PT right away. After seeming to get better and running again ( on a boring HS track ) it actually started feeling worse then it did before. I will go for a second opinion see if I can find a Dr. who sees more of this. Doc who took this X-ray told me we only have so many miles we can run. I did not like that to much.
As already stated, the highlighted statement is enough for you to find a different doctor. I’ve heard doctors tell that to “injury prone” people, only to have them be just fine indefinitely with treatment and rehab with a more forward-thinking doctor.
Most likely injured it from overuse. The First Dr. Tried PT right away. After seeming to get better and running again ( on a boring HS track ) it actually started feeling worse then it did before. I will go for a second opinion see if I can find a Dr. who sees more of this. Doc who took this X-ray told me we only have so many miles we can run. I did not like that to much.
As already stated, the highlighted statement is enough for you to find a different doctor. I’ve heard doctors tell that to “injury prone” people, only to have them be just fine indefinitely with treatment and rehab with a more forward-thinking doctor.
Exactly. Initially, my surgeon told me that repetitive impact sports days were over for me. Prior to surgery, I managed to get him ‘on-board’ to my way of thinking. He did an amazing job, for which I’ve thanked him repeatedly and have emailed him several of my finisher pictures. The surgeon who did my follow-up care was also of the mind that anything more than gentle walking and swimming was never to happen again. Honestly, I wouldn’t let that man near me with a scalpel. I went back to him for several followups so that I could personally see the x-rays and to show him that with belief and motivation virtually anything is possible. I’ve sent him finisher pics to a) hopefully change his attitude when dealing with other patients, b) to continue to prove to him that he was narrow minded. Fortunately, my best friend was on-sight at the time of accident to set my mind and attitude straight, and I gathered very supportive and positive professionals to accelerate my recovery.
Edit: The attached x-ray shows a medial malleolus fx and a cranially shifted 2mm crushing of the superior talocrural articulating surface. It doesn’t show the 3mm distal-anterior tibial fragment that was not reattached but instead removed. Fortunately, the syndesmosis was intact. But the joint capsule did have to be opened in order to replace the distal end of the tibia.