Acutely painful small lump on Achilles tendon

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Acutely painful small lump on Achilles tendon

by Jonathan Small
(Southam, Warwickshire, UK)

I am a Podiatrist in the UK who has seen a patient referred by an Orthopaedic Foot Surgeon for an acutely painful lump on his left Achilles tendon. The lump is maximum 5mm in diameter and located over the middle of the tendon approx. 3cm proximal to the calcaneal enthesis.

It has been present for 6 months, and the patient suspected a cyst. It can hurt at anytime, even in bed at night, and is not apparently linked to activity levels.

It is intense pain that temporarily prevents continued weight-bearing, but eases spontaneously after just 2 minutes.

The surgeon categorically states that there is no evidence of cyst or Achilles ruptures on ultrasound scan. He wondered if there was a biomechanical cause, hence referral to myself.

However, my assessment revealed no gross abnormalities except bilaterally externally rotated hips and mild forefoot varus causing mildly excessive pronation in the sub-talar joint during midstance phase of gait.

Unlike the surgeon, I found a test that did illicit the symptoms in full - namely static repeat heel raises with knee straight as I was testing gastroc power.

The only time I have seen symptoms like it is in acute injury situations, but those symptoms don't subside spontaneously after just a couple of minutes!

The lump is tender when palpated, but not as painful as the test induced. It does not move or float.

Apparently 15+ years ago, the patient did damage an Achilles tendon playing sport, but does not know which one. The left tendon does appear thickened compared to the right.

This appears to be an unusual case. My online research suggests tendonosis, but the surgeon thinks tendonitis. I'd be grateful for your thoughts.

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Joshua Answers:

Hi Jonathon. It'd be happy to add whatever I may to the investigation.

Working on the assumptions that there is no cyst, no tumor, no significant rip/tear, nothing else medical that would have shown up on ultrasound, here's my thoughts.

1. So 5mm is about the size of a pea. Which to me means that there was a specific site of tiny rip/tear, and over time the body has laid down scar tissue. Microscopic tears to that new scar tissue structure and the body lays down more scar tissue. Over and over until there's a nodule of scar tissue.

The nervous system reads this as an ongoing injury, and treats it as such.

2. Static strain results in pain that goes away quickly. But also hurts other times, like in bed at night.

Acute injury pain doesn't go away that fast, as you say. But, for instance, bad shin splints can -force- a runner to stop running due to the pain, and then not hurt a couple minutes later.

It's quite possible that the same dynamic is in place here. There's definitely pain enhancing chemical from the inflammation process in place, but as the nervous system also plays a role, if it thinks there is danger, it can create pain to make you stop doing the dangerous activity.

I would think the pain from static strain that goes away quickly is more a function of the nervous system trying to avoid injury to a structure it is concerned about.

And of course, everybody and their pain is a little different, what you've described doesn't surprise or concern me.

And the pain at night is (probably) basically from the near constant release of pain enhancing chemical due to chronic, tiny injury as every day, every step has the potential to rip one of those microscopic scar tissue fibers and set the whole thing in motion again.

3. There could be some Tendonosis involved, there usually is with Achilles Tendonitis, but it sounds more consistent with the above.

4. For specific spots like this, specific massage on the tendon. I would have the client:

A. Ice massage the tendon itself frequently throughout the day, and/or

B. Just massage with finger tip. Across the fibers, circles, compressions, however one wants to do it.

Essentially, that nodule is a dry, fragile, crunchy sponge. Rub it enough and it will reshape into a soft, mobile, gummy sponge.

When it's fragile it gets frequent microscopic reinjury. When it's gummy and mobile, it structurally isn't as prone to that frequent reinjury.

There are other factors at play, of course, but one HAS to restucture that nodule. It likely won't go away, but it doesn't need to vanish, it just needs to be more squishy/gummy and less dry/crunchy/fragile.

I know that's highly technical lingo there....:)

(p.s. you submitted this on the public forum so I'll assume it's fine to post for all to see/learn from.)

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Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.
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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com

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Acutely painful small lump on Achilles tendon

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Feb 21, 2010
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PART 2 - Thank you for your thoughts - Acutely painful small lump on Achilles tendon
by: Jonathan

That information is most useful. Thank you for that.

At my initial assessment, I issued him with a gel heel pad to reduce strain on the tendon and absorb shock on initial contact. I am due to review him next week, and was planning some deep massage on the triceps surae, but will extend that to localised work on the nodule as per your recommendations.

I'll also get him to ice the area regularly, and will see how that goes.

One other query though - would a nodule of scar tissue not have shown up on the ultrasound scan?

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Joshua Comments:

Would a nodule of scar tissue not have shown up on the ultrasound scan?

I would think it would. Did the surgeon mention it, is it in the report? Did you do the measurements, or is that from the ultrasound?

Aug 22, 2010
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Lump on Achilles tendon getting bigger
by: Anonymous

I have suffered from exactly the same condition for almost 6 months. The pain is only really bad when I wear hiking boots - that's unfortunate as I'm booked to do the SW Coast Path in September. I've had Physiotherapy, ice packs, exercise, bought two new pairs of hiking boots, etc... but nothing seems to work and the lump is getting bigger. I did suffer an injury to it about 20 years ago, playing netball, but my trainer at the time said it was nothing to worry about and I didn't seek medical help. I guess I just want to know, is this something I'm just going to have to live with now? I'm 57 by the way, female, and fit and active.

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Joshua Comments:

Hi Fit and Active.

I'd really rather that you -not- live with it.

What exactly have you done for this so far, specifically? What does physio, exercise, icing, etc mean exactly?

It's amazing what happens with the RIGHT tool or the RIGHT bit of knowledge....

Sep 06, 2010
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Same injury but only 5 weeks old from Ed
by: ED

By the sounds of things i have suffered a very similar injury to this, but my onset started immidiately after a training session 5 weeks ago.

Doing pre-season training for rugby involves a lot of running on hard ground, and after the session i felt as if i'd slightly pulled my lower calf.

A few days later i noticed a small lump at the base of my achilles tendon, but i tried to run it off. I found it ok when jogging but as soon as i tried to accelerate it would become too painful to continue.

A physio at the club has been massaging the lump and doing a little ultrasound which has seen it decrease in size but the season is now starting and i'm desperate to get back to full training instead of sitting on a bike. You mentioned that the lump will not disappear completely, but when is the right time to know when to get back into running without re-injury?

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Joshua Comments:

Hey Ed.

The lump is a combination of scar tissue build up and inflammation/swelling.

You -should- massage it and keep it mobile and ice it.

But, that lump really isn't the problem, though it's certainly the focus of the symptom.

Get a stick, or a rolling pin, or somebody's forearm, and work all the backside of your lower leg. Gasctocs and the Soleus (which is under the Achilles tendon, kind of).

Imagine that it's all wrapped in tight saran wrap. Your job is to manually lengthen/stretch all the saran wrap that is constricting the structures of you lower leg.

Loosen all that, and there will be less constant tension on the tendon/that lump on your tendon, so there will be less tension and microtear.

You will also be able to do more work with less wear and tear. Structures work better and have more potential when they are loose and mobile, as opposed to taut 24/7 like yours are.

Make sense?

Sep 07, 2010
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Here's what I've done for the lump on my Achilles Tendon
by: Anonymous

Hi Joshua
Thanks for commenting. Here's my response.
Exercise - I stand on a step with good shoes on, and drop my heels below the level of the step. I've been told it will lengthen and strengthen the calf muscle.
Icing - my Physio told me to sit with ice pack on it at least twice a day. I did this for about 3 weeks but it didn't seem to make any difference.
Physio - magnetic ultrasound (where they massage the area with something that vibrates the tissue) + acupuncture.
Despite all this, the lump is getting bigger and sometimes my leg aches horribly, all the way up to my thigh. I'm still walking and not curtailing my activities, but I haven't worn my hiking boots for months. I'm wearing hiking shoes that don't touch the painful area.
Useful site - thanks.

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Joshua Comments:

Hey there.

I was just on vacation for a week, and I wore a pair of boots I wear once a year. Something about how they were stored, apparantely, had a fold/crease rubbing against my Achilles Tendon.

It didn't hurt the first day. The second day I couldn't even wear them, because ANY amount of pressure on my Achilles tendon while it lengthened just about made me scream.

Point being, yes, if it hurts to wear a shoe/boot that touches the spot, don't wear them.

I think it's safe to say that you don't just have a lump, you have a tendon bruise.

Tendon bruises are a special kind of pain....

So.

1. Make sure you're doing Magnesium for Tendonitis.

2. Massage the lower leg like I describe in the post right before this one.

3. Exercise as you described, good.

4. If you're going to ice, ice massage.

5. Physio as described, *shrug* sure if you feel it's helping.

Sep 13, 2010
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SlipHip
by: Ronny

Jonathan said: "However, my assessment revealed no gross abnormalities except bilaterally externally rotated hips and mild forefoot varus causing mildly excessive pronation in the sub-talar joint during midstance phase of gait".

You may have solved my problem. At 14 I had a slipped capital femoral epiphysis and they had to pin my hip. 39 now.

It's like the bad leg is shorter than the other. So I walk on the outside-edge of my right foot
Seven years ago, I tried a calf exercise and got a stabbing pain in my lower right calf. Couldn't walk for weeks, exercise for months. No doctor.

Later I noticed a lump on the upper Achilles tendon. May have been there for years but not noticeable with overweight calves.

But it's now there for at least 7 years and it's never once hurt since the injury.

I finally concluded it's simply overdeveloped from the way I walk on my foot, as well as scar tissue from micro tears from being overweight, plus the major tear.

Since I don't have $900 for the clinic and tests, I'm going with that :)

I noticed my lump again tonight and searched internet for curiosity, and I came across your comment, indicating the same conclusion I reached, making me feel reassured in my conclusion.

Thanks

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Joshua Comments:

You're welcome! :)

Lumps are only a problem if they're a problem. The body forms to the stresses placed upon it. So if that spot needs to be tougher/stronger, the body will make it so.

If the lump is from continued microtrauma, that's a different story. In that case, it -may- hurt some day.

Either way, it wouldn't be a bad idea to rub that lump for a couple minutes, every single day, just to keep it mobile, loose, happy, etc.

Oct 09, 2010
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lump on my achilles goes away
by: krazykev

I have this lump on my right achilles, i've been told its scare tissue, if i rub,pinch and squeeze it, it will go away and no pain for a couple of day but soon comes back, is it ok to do this every day to get rid of this? i also stetch it 3 times aday aswell as doing calf raises to strengthen them. P.S. I do running as a sport.

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Joshua Comments:

Just so I'm understanding this correctly...you have a lump on your achilles tendon.

And it goes away when you massage it? Or just the pain goes away?

Oct 10, 2010
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Lump on achilles and running
by: krazykev

the lump and pain seems to go away for a couple of days but gradually come back, i am still running in between this.

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Joshua Comments:

Well, that sounds like swelling. If you have a small active spot of rip/tear, then there will be a big Process of Inflammation.

And there's a Tendonitis in place, meaning there will be an ongoing process of new scar tissue build up, which will rip and tear and trigger more inflammation and swelling and pain and scar tissue build up.

A. Ice massage that spot. A lot.
B. Stretch your Gastrocs and Soleus. Gently, a lot.

Oct 11, 2010
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lump on achilles comes and goes, and running
by: krazykev

Thank you, will let you know how i get on.

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Joshua Comments:

Please do!

Jan 21, 2011
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painful lump on achilles tendon
by: susansmum

I have suffered with this condition on and off for many years. Had knee surgery to remove torn cartilage 40 years ago and the knee joint is now badly affected by osteo-arthritis and affects the way I walk. I need a knee replacement but am told I'm too young at 59! I don't do sports of any kind, and always wear flat/low heeled shoes. The lump is always biggest and most painful first thing in the morning and eases within a few minutes, could the change in my gait have caused this?

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Joshua Comments:

Hello Susansmum.

59 is too young? Seems to like a pretty good time to get your body chopped on. The older you are, the slower you heal, etc. Granted, they have a 15-20 year lifespan last I heard, so you certainly don't want to be needing another major surgery at 85.

Yes, absolutely, gait change can cause Achilles Tendonitis.

And you have decades of growing compensation pattern. Which means while we're born perfect with everything working optimally, overtime, we compensate more and more and get less functionally optimal. Which basically means some muscles are working harder than others, and harder then they should be.

Throw in a gimpy knee and having to compensate around that pain and dysfunction, and it makes sense that pain and problem is showing up in other places.

Mar 20, 2011
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Oh, the pain, cyst in Achilles where it meets the heel
by: Jill

I have had a "cyst" on the place where the Achilles tendon attaches to my right heel for probably 15 years now. I was an avid runner at the time, but do not recall a specific injury. The spot feels like a bebe under the skin and is VERY painful when pushed... sometimes when I accidentally hit it on my shoe while putting it on, the pain will almost take me to the ground. I also experience pain during resting times, in the way of a mild ache... usually after a day of wearing flip flops or a shoe without a back. I have no idea whether that's the reason, but there seems to be a correlation. I did see my primary doctor last year about it and he sent me to a physical therapist to do some mechanics. I have flat feet... and I seem to remember him saying that my right leg muscles were unusually weaker. He sent me to an orthotics place for some custom inserts. I wear them in my sneakers, but haven't noticed any change at all in the pain or size of the cyst. Now, I am experiencing some nerve entrapment pain on the top of my foot and have no idea whether the two issues are related. I am a 38 year old female... very active, with 2 young children. I am underweight, so excessive weight is not an issue. I have tried massaging, icing, and stretching, but nothing has made a difference. Would love to hear any new ideas on exactly what this is.

SO glad to have found this site! THANK YOU!

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Joshua Comments:

Hi Jill.

I don't have much to say about the cyst....rather out of my realm.

Still, there''s always something to say... :)

Overall, my thought is, you have too much tension/tightness/constriction going on. Possibly that 'weakness' is due to muscles being TOO TIGHT and therefor they don't have much strength/contraction left available.

Get in there and open up the back of the lower leg.

Also, if you were an avid runner, if you have two kids (assuming you went through pregnancy with both) and you're underweight, then it's safe to say you could use some nutritional bolstering. Pregnancy takes a lot out of you. "Avid Running" takes a lot out of you. Etc.

On a separate tangent, do some googling for 'cyst' and 'iodine'.

Iodine (make sure you find the right kind) is proven to be VERY effective at removing cysts. Again, I don't know much about cysts in particular, and don't run across the topic too often. Having said that, it will be worth your effort to look into iodine for cysts.

Mar 31, 2011
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Painful lump on heel
by: Katefromwarwickshire

I bought some shoes which were fine at first,then i noticed they rubbed,developed a small lump above my heel on the tendon,(i think),its now extremely painful to walk,in all footwear more or less,the area is red and quite warm to the touch,i am considering going to see the doctor but he is quite useless..

Its been awhile now and its really stressing me out,as i have to wear trainers all of the time,will it go away???

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Joshua Comments:

Last year I wore a pair of boots I wear once a year for about a week (camping). Turns out I stored them in a scrunched up position all year.

So I wore them all day and night when I first got there. Didn't hurt at the time.

The next morning, and for the entire rest of the week, I couldn't wear ANYTHING that even touched the back of my heel/Achilles. It was fine unless I had a shoe on and took a step.

Essentially, I, and seemingly you, bruised the tendon. Tendon bruises HURT (generally just when touched or stressed, fine at rest.

The pain and redness is due to the inflammation process.

Ice. Lots of it. Often. And be patient. It's not fast. It's not a bad thing, it's just that tendon tissue is stubborn, and you have to work at it.

Apr 29, 2011
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achilles tendon cyst
by: Anonymous

I had knee replacement two years ago. During the physical therapy that followed, I developed tendonitis in the Achilles tendon of that same leg. It was so painful I couldn't put any weight on the foot-- hurt worse than the knee. Soon after I noticed a lump about three inches above my ankle on the back of my leg. The doctors said it was a cyst and not to worry. However, the sharp, stabbing, burning pain that radiates down into my ankle from this lump has become a real problem.
Some of the interventions that I have tried are: ice, stretching, massage and NSAIDs. Any relief I have found has been weak and fleeting. Thanks to this site I will speak firmly with my doctor at my next check-up about not ignoring this problem any longer.
And a comment for the lady with the bad knee, I had an Otis knee done at age 54. Best move I ever made!

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Joshua Comments:

Well -if- it's for sure a cyst, and -if- it's causing your symptoms, then yeah, no reason to not to cut that puppy out.

Jun 10, 2011
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thanks
by: april

your advice was so straight forward!! thanks so much buddy!! usually a person cant understand yu know? totally appreciate it

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Joshua Comments:

I try to keep it simple and in the realm of common sense.

Less talk, more action!

Jul 07, 2011
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Extreme achillies pain, and have already had Planter Fasciitis surgery on both feet
by: Jennifer

I have a knot on my achillies that is extremely sore to the touch. I have had plantar Fasciitis surgery on both feet. I had a vertical tear in my right achilles so my podiatrist castes it for 3 weeks and it was fine. Well now I have almost the same kind of painful knot on my left foot with the exception of the knot being at the top where is connects to my calf.

I guess I'm wondering if you think it could be a vertical tear? And is casting a regular treatment? Thanks

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Joshua Comments:

Hello Jennifer.

Is casting a regular treatment? Yes. Is it particularly effective? Not so much. Not in the long run, anyway, as you're experiencing.

I have no way of knowing if there's a tear or not, unfortunately.

It works kind of like this:

1. Muscles get tighter and tighter.

2. Pain Causing Dynamic grows.

3. Plantar Fasciitis Symptoms

4. Plantar Fasciitis Surgery

5. Over time, more pain, more problem. Compensation pattern continues to develop and sooner or later you develop other pain and problem.

6. Tears happen when the body can no longer handle normal daily stresses of movement etc.

Want to decrease pain symptoms and make your tissue happy and healthy again? Then I suggest either 'The Plantar Fasciitis Treatment That Works' or Reversing Achilles Tendonitis ebook. (But not both!)

You can absolutely lower your pain levels with either of those.

Want a FULL recovery from it all, surgeries and everythin? Then find out about The ARPwave System.

More questions, more answers.

Jul 27, 2011
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Two bumps Above Ankle Causing Pain
by: Sue

I've been getting for sometime 2 bumps a couple of inches above my ankle bone when I jog. Now they seem to be showing up when I walk (at a decent pace).

While I'm walking or running it feels fine but when I stop it feels like something is tearing.

The pain subsides relatively quickly and the bumps recede but no longer seem to completely disappear. It seems similar to what you were discussing above relating to the achilles tendon but different location. In researching I've come across fascial hernia, chronic compartment syndrome but can't seem to pinpoint anything.

Any thought are appreciated. Hard to show a doctor unless I run first! Did find this picture on line and my bumps are very similar just closer to my ankle and more on the outside of my leg.

http://dl.dropbox.com/u/523401/photo.jpg

thanks
sue

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Joshua Comments:

Hi Sue.

Could be some in and out herniation (unlikely), and minor compartment syndrome could be at play, but it sounds like you're experiencing chronic irritation and inflammation, thus the swelling and going away.

Inflammation includes the release of pain causing chemical which makes everything hurt BAD. Your system is currently doing a great job of cycling that through (reducing the pain and swelling).

Overall, your muscles are so tight they're not absorbing force properly, and all that force has to go somewhere, which is causing problems.

Your basic options are my Reversing Achilles Tendonitis ebook

or to pull out the bigger gun, The ARPwave System.

More questions, more answers.

Aug 03, 2011
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Similar Injury to Acutely painful small lump on Achilles tendon
by: Lexi

I never have had any severe injuries before. I had a problem with my ankle during track season due to unsupportive shoes, but the problems went away when I got new shoes.

I have a small lump on my Achilles tendon on my left foot, and it only hurts slightly - usually when touched and sometimes while walking/etc. It reoccurs at random times. Have any ideas as to what this is and how to treat it?

[Take to notice I have had no previous injuries]

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Joshua Comments:

Hi Lexi.

Well, the pain went away, but the problem didn't go away.

You ran ran ran, muscles slowly got tighter and tighter, new shoes irritated the dynamic, you changed shoes and the pain settled down but the structures were still tight etc.

Now your muscles aren't firing optimally and force is transferring to places it's not supposed to go, specifically that lump on your Achilles.

What have you done for it so far, self care wise, to help address the problem?

Sep 10, 2011
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big achilles tendon lump
by: Cassie

Hello. I was wondering if anyone had any advice....I hurt my achilles tendon on july 30th. I have just started running again and did the elliptical for six weeks since it did not irritate the tendon. Now I have a large lump in my achilles tendon area but it is not painful to run at all. Should I still run? Should I be very worried about this or is this a common sign of healing for the tendon?

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Joshua Comments:

Hi Cassie.

Is it common? Yes.

Does it have some relationship to healing? Yes.

Does that mean it's been healing as good as new? No.

Is it a problem? Not necessarily.

Can you make it better with icing and massage? Absolutely!

Can you make the lump go away? Probably not.

Can you be totally 'healthy' and active with the lump? Absolutely! IF you ice and massage to make the ecology of the lower leg good and healthy again.

Nov 10, 2011
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Lump on Achillies Tendon
by: Anonymous

Thanks for your posts.
I ruptured my achillies and bust my calf muscle playing football about 14 years ago (29). This year i aggravated my achillies playing football with the kids and since then have had a lump appear along with extremely tender achillies.

will give the massage technique a go each day and see if it can make it more malleable as you advised.

Nice to see some sense being written on this subject on the internet!

Cheers

John

Joshua Comments:

Hey John.

Is it the same side as the side you ruptured?

Let us know how it goes.

Nov 20, 2011
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achilles tendon lump after hurting the achilles stopping a door
by: Lisa

Hi about 5 months ago I hurt my achilles when I stood up but the back of my foot was under a heavy metal door and my achilles took the full force of me getting up, it was extemly painful and I fell to the floor , I could hardly walk on it to start with but I rested it iced it and took ibuprofen it improved a bit over time but is still painful and tight after rest or if I walk alot and I also have a hard painful lump on my tendon,is this normal for it to take this long to heal , and also what do you think I have done. thank you. Lisa

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Joshua Comments:

Hi Lisa.

I have no way of telling what you've done from here.

I also don't know what the time period you're talking about is.

More details, more details...

Nov 21, 2011
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Lisa Replies -- achilles tendon lump after hurting the achilles stopping a door
by: Lisa

it was about 5 months ago that I hurt it, while the first extreme pain has died down I been left with a constant pain ,worse if I stand on tip toes and after rest,and a hard painful lump .

but After 5 months I'm really hoping it will get better soon. stretching it does help a little, but its just not going away. Lisa

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Joshua Comments:

So, your rested it, and you iced it.

What exactly did icing it look like? Meaning, what did you do, exactly?

Nov 21, 2011
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re: achilles tendon lump after hurting the achilles stopping a door
by: lisa

frozen peas, and then I bought a jel thing that you keep in the fridge until you use it by wrapping it around your ankle.

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Joshua Comments:

I suggest Ice Dipping and Ice Massaging.

Ice Packs just aren't going to do it.

Learn How To Reduce Inflammation

Dec 02, 2011
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Achilles nodule after ignoring it until I couldn't walk
by: Scott

I hurt my achilles tendon 3 years ago and completely ignored it for about six months. I play sports and do a lot of calf work in the gym.

After ignoring it for so long I could not walk, it wouldn't loosen up. For the last 2.5 years I have been in and out of a air cast boot. I have actually gone through 5 of these boots. I have a nodule on my achilles that is swelling and scar tissue. It has gotten a lot better in the last 2.5 years but it still has not healed 100%.

I was schedules to have surgery on it (debriement) but at the last minute decided not to because the recovery is a year from the surgery. The most aggressive thing I do is go to work and stand and walk a bit with a heel lift in my shoe. At the end of the day I put my air cast boot back on to rest it and let it heal.

I have gone to so many specialists and they all say it should heal. I have had platlet rich plasma injections (where they inject your blood in the achilles to help promote healing), and radial shock wave therapy. Nothing seems to work except for resting it.

I have heard that chronic achilles tendiopathy usually takes about 3 years to heal if you really baby it. I am thinking it will never heal. Is there anybody out there that has completely healed from this thing? I have had 2 knee sugeries and both shoulders reconstructed so I am statring to think I should have had surgery on my achilles.

Continued In Next Post

Dec 06, 2011
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Joshua Responds -- Achilles nodule after ignoring it until I couldn't walk
by: The Tendonitis Expert

Joshua Comments:

Hey Scott.

I know huh, a year to recover just from the surgery....not particularly compelling.

This will be useful for you: Why does rest help but PRP and shockwave therapy don't help?

Because A. PRP and shockwave therapy target the symptom, not the cause and B. Rest stops new irritation to an irritable dynamic.

But 'rest' is not 'relaxation'. See: Rest and Relaxation

So you have scar tissue build up. Ok. Is that a problem? Not really, and, it's a symptom. So while it's important (sometimes) to deal with scar tissue build up, the REAL problem is what's causing the biomechanical dysfunction in the first place.

And it changes the conversation a little bit if you have some actual tear in the tendon or no.

A year's worth of recovery from debridement surgery seems like wasted time and effort if the spot on the tendon isn't the CAUSE of the problem.

And all those specialists say it should heal...but it's not...why? Because they're not looking at the bigger picture. That spot on the tendon is there for a reason. And the reason is not 'there's a spot on the tendon that should heal'.

So. Moving on.

You're partly right. It's never going to heal...unless you help it heal.

I see two options.

Option #1 is my Reversing Achilles Tendonitis ebook.

For $20 and the support I provide with that, it's the best cheap option out there. It will take some time and diligence on your part. But I don't see any reason you can't get AT LEAST 50% better and more likely at least 80%.

Though considering you have knee and shoulder issue also, and depending on your motivation level, I HIGHLY urge you to consider The ARPwave System.

It can heal ruptured Achilles Tendons and total ACL tears without surgery, 6-8 week full recovery...it can correct what you have going on.

You have an electrical disruption (compensation pattern, call it whatever you want) keeping muscles from firing properly.

Totally fixable.

My ebook will help A LOT, but the ARPwave operates at an entirely different level, and can fix issues I can't even begin to touch.

Check out the ARPwave link, then let's talk if you're interested.

Dec 08, 2011
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Right achilles tendon hurts when running
by: Cassie

Hey its me again. this time I hurt my right achilles tendon I believe. I hurt it while running on thanksgiving. I rested for a few days and tried to run on December first again but it hurt after 10 minutes in of running. I haven't ran since then and I have only done the elliptical for a couple days. There is a small bruise on the back of my heal. It does not hurt to walk on it or anything but after hurting it on thanksgiving It hurt to walk up the stairs for a couple days. How long do you think this will take to heal?

Also what exercises should I do to help strengthen my tendons now that I injured both of them.

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Joshua Comments:

Hi Cassie.

I don't know how long it will take to heal. What are you doing for self-care to help speed it along?

Dec 09, 2011
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Right Achilles Tendon hurts while running
by: Cassie

Hey Joshua, well I havent been exercising hardly at all. I really dont know what else to do to make it heal faster. I have been scared to try to run on it again.

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Joshua Comments:

Not running on it is an ok plan for now.

So it sounds like you're not doing any self care for it other than rest. True/false?

Remind me, what did we talk about last time? (Because I'm going to ask you why you aren't doing any of those things for your lower leg, if such is the case.)

Dec 09, 2011
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Cassie responds - Right achilles tendon pain and ankle pain
by: Cassie

Hey Joshua. The last time I was just wearing a brace for my left leg nothing major really. That was a pretty serious injury. I couldn't walk well for about a week. That was when I hurt myself in July. I really want to try to run again tomorrow and see how it goes. really the pain more so feels that it is coming from a tendon of the inner ankle but it feels like it is somehow connected to the achilles.

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Joshua Comments:

1. Pain Causing Dynamic

2. Magnesium for Tendonitis

3. Get a 5 gallon bucket and learn How To Reduce Inflammation.

4. Self massage. In short, if it's tight or if it hurts, rub it. Little bits frequently throughout the day.

Dec 31, 2011
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Acillies swelling,
by: Julie B

Hi,
I have pain in my Achilles area, I get severe swelling all around my ankle and foot and have a lump/ nodule just above my heel in the tendon, if this is touched or bumped it can send me into space, very painful, I can't wear boots as these touch the lump, I do wear orthotic insoles in my shoes as I have a slight inversion. The pain is Fairly constant but is worse first thing in the morning, it takes me ages to get down stairs. ( I'm 45' but in general good health and fitness).
I used to run and walk a lot but had a stress fracture in he other leg so this has slowed me down, Iam not overweight BMI 23.4 so this is not the problem, I use ice spray, anti inflammitary gel, and compression bandages, Any other advice very welcome ?
Thanks,
Julie

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Joshua Comments:

Hi Julie.

Have you had an MRI? It might be worth it just to see the integrity of the tendon.

As far as suggestions for the pain, swelling, and overall health of the Achilles, see my response to Cassie in the post just previous to this one.

Also, I suggest my Reversing Achilles Tendonitis ebook.

You have something serious going on. It's worth it to deal with it effectively.

Jan 05, 2012
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Another nodule on the achilles tendon
by: Robin

Hi,

I also have a little strange bump in one achilles. Just sort of noticed there one day. It is more on the outside edge of the achilles rather than down the middle. And is almost like a thin bit of string running parallel to the ground (ie. Across the side of the tendon perpendicular to it) Not really causing much pain at all. When the foot is just resting or I am standing you can barely feel it. However if I stand on those toes it is quite obvious to touch. Been doing stretching on my lower legs now and a bit of massage so hope that helps. Rubbing it or whatever doesn't cause much discomfort at all - and when I run I don't really notice it. Should I give it a bit of direct massage to the lump every day as you note above ?

I assume this sounds like not really a big deal and I should continue loosening up my lower legs and continue the exercise ? Started yoga too which is definitely loosening me up. Hopefully that helps the lower legs - as they have always got pretty tight for me after running.

Thanks in advance.

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Joshua Comments:

Hi Robin.

Yes, ultimately you have to lengthen and relax muscle and soften tendon tissue (more like gummy bear and less like dry crunchy sponge).

Keep at it, keep us updated.

Jan 09, 2012
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Thanks
by: Anonymous

Thank you - I will keep on at it as its not causing pain and continue with the loosening up.

Jan 11, 2012
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Lump on Left Achilles, runner, pain started 4 weeks ago
by: Muskrat

I have had a lump on my Left Achilles (approximately 6 inches above the heel) for about 4 weeks now. I am an avid runner and had been training for a marathon. The pain from this started about 4 weeks ago. I continued running, as usually it would "loosen" up after a few minutes of activity, but then it would always hurt quite a bit that night. I would ice - and the pain would be "ok" the next day, but never totally gone. I had a 1/2 marathon coming up, so I took 2 weeks off - no running at all - to let me Achilles heal. I ran the 1/2. Approximately 4-5 miles in - my Achilles started hurting. I finished the 1/2 marathon (barely) :)

My left Achilles was very sore the next day - but I had a 5 mile run to go do. Ran the 5 miles - and really should not have. (I could barely walk).

I went and bought one of those "walking boots" and immobilized it. It has been immobile for 9 days now. I can walk on it - but it is still sore. I ice it almost daily.

I had an MRI - and the doctor said there is no sign of a tear or rupture. My concern is the lump that won't go away.

My questions are:

1) Should I walk on it / run easily on it to keep it active?
2) Should I do other training like a cycle / eliptical while letting it heal?
3) Should I stretch it or try to immobilize it.

I am planning on not doing any running for 4-6 weeks - then easing back into my maraton training.

I am just really concerned about the lump.

Thanks.

Jan 11, 2012
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Joshua Responds - Muskrat - lump on achilles from running
by: The Tendonitis Expert

Joshua Comments:

Hi Muskrat.

To questions #1 and #2 I say yes. (Walking certainly).

To #3 I say NO, you should never immobilize in this situation. Toss that walking boot, or put it in the closet for a rainy day.

Concern is good. Keep that. But let's redirect it.

Healing isn't the problem. Function is the problem.

The lump isn't a problem. It's a symptom and a clue.

The body shapes itself to the forces placed upon it. The lump is forming because there's undue stress on that spot. Which includes tiny rips/tears and scar tissue build up.

You've iced and gotten a certain amount of results/benefit. Great. In general, I'm going to assert your're not doing enough self care, and more importantly, not doing enough of the RIGHT self care.

From an ARPwave perspective, muscles are shock absorbers. When they aren't doing their job correctly, they're not absorbing force (every step down the road) and all that force has to go SOMEWHERE.

Muscles absorb force. Tendons don't. Achilles tendons tear and rupture because muscles aren't absorbing force, it's all going to the spot that tears, and eventually it gives way from too much stress/tension/force.

You're in the baby stages of that. (Not saying you're going to rupture, just saying that lack of optimal muscle function is the mechanism in place every step down the road.)

From the perspective of my Reversing Achilles Tendonitis ebook, structures are too tight and inflammation is causing issues. That is totally reversible.

6 weeks off isn't going to help nor fix anything, I promise. 6 weeks off with appropriate self care very likely will. Non-adequate self care and rest won't fix anything....

My ebook is the cheap (but effective) way, getting an ARPwave unit in your home is the less cheap way. It's the big gun, and it's....amazing. (Says the 53 year old lady that trained with it to run 93 marathons in 93 days.)

So it depends on your motivation level. At this point, it's going to take something to correct what you have going on. If you want to get out of pain and start getting back on the road, start with the ebook and keep me updated. If you are serious about it and it's super important to you to put in as many miles as you can, see: The ARPwave System).

Jan 13, 2012
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Lump on left achilles tendon
by: Anonymous

Hello! I have been avidly reading all the posts and your responses on here; perhaps you can help me?

I have had a very painful lump on my left achilles for four weeks now which I suspect may have been brought on by going back to ballet class again after a 10 year break (I'm now 30).

Around the same time, however, I also had an issue with a new pair of walking boots which were ankle height and rubbing slightly - I got a pain so bad in my left achilles that I had to take them off (but had no problem with my right foot) and I have sadly never been able to wear them since. The lump in left achilles is now painful in some of my other footwear which had previously been very comfortable.

The pain is worst in the morning - it's like my left ankle has completely seized up and I have to hobble. I have iced the area on and off and I do massage it daily between my fingers, but I want to go back to ballet and aerobics and get fit, but I'm worried I won't be able to handle the jumps etc and may injure myself further.

Could you please give me your prognosis and advise a course of treatment to get me active again?

Thank you!

Lucy

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Joshua Comments:

Hi Lucy.

No prognosis yet.

1. Was it fine before you wore the boots?

2. Did you have a lump before the boots (and the boots aggravated what was already there)?

3. Are the boots shaped in such a way that there was a curve or ridge that was pressing into your Achilles?

4. If so, does it press in where the lump is, or elsewhere?

5. Did the pain come on fast or slow?

6. Any other details along these lines.

Jan 24, 2012
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Desperate for advice, hypermobile with painful lump on Achilles tendon
by: Elaine

I have been reading all the posted comments and still fell compelled to ask about myself.
I wore a pair of wellies that folded in at the back of the heel when I walked. My strides were large and quick trying to keep up with my son.This caused a lump to form on my Achilles. This was 8 weeks ago.
I have hyper-mobility and am overly flexible in my back, hips, knees and ankles. I saw a physio who told me to do some calf stretches she also advised me to see a podiatrist. The podiatrist said it was my hips flexing forward, knees bending to the middle and my ankles rolling into the center the was causing all the pain. She has strapped my leg so that the strapping does the work of my Achilles and has given me angled pads to prevent me from walking on the inside of my feet. Also i have been given a range of core exercise to strengthen my back, hips and stomach muscles. This however has stopped me from doing my calf stretches and I am not sure if this is helping.I do the massage and ice as suggested by both my physio, podiatrist and yourself.
To top it all I am on trial at my new place of work and do not want to take time off. I am on my feet constantly for 8 to 9 hours at a time and regularly have to run the 3 flights of stairs carrying heavy equipment. I am 2 stone overweight which I know is bad for my hyper-mobility and am trying to find a way to burn fat and not damage my ankle. I cycle and use a cross-trainer but am I doing the right thing.

I do not want to lose my job and am desperate to know that I am doing the right thing. I am 44 and willing to do what it takes to get this sorted.

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Joshua Comments:

Hi Elaine.

I hear that your motivated. Ok, great.

1. For a variety of reasons including pain and weight gain/holding, get your VitaminD level checked and then get it to between 50-80 ng/ml.

2. Go off ALL gluten for the next two months. Among other ills, it is an inflammatory agent (causing pain, and weight gain, and nutritional deficiency).

3. Don't stretch. Massage. That's a specific stretch. You probably don't need to stretch anyway, as hypermobile folks generally don't have 'tight' muscles, but there is other stuff going on.

The muscle needs new blood full of nutrition.

4. See: Magnesium for Tendonitis. Get on it. As much as you can get into and onto you. Take care of 'tolerance level'.

Question: Was the shoe rubbing on the achilles tendon? Did it irritate it due to pressue and friction? Or is it that you were in new shoes and the change in normalacy caused things to go haywire?

Jan 26, 2012
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I'm cured!
by: Anonymous

Hi Joshua
I've been meaning to post this thank you note for ages - sorry, life gets busy. I've just read Jonathan's post above and it sounds like his client had exactly what I had - still undiagnosed.

On Joshua's recommendations I religiously iced twice a day and massaged as often as I could throughout the day. I also did exercises on the step - lowering the heel below the step being careful to put all my weight on the other foot to return the injured foot to the starting position. Joshua said the lump needed to become soft and pliable instead of hard and crackly.

Eventually I did persevere with this regime (it wasn't easy)and the problem disappeared after about 6 months of this treatment. As this had become a chronic problem that had been going on for some 12 months before I found this website, I'm certain it was the icing, the massage and exercises that cured it.

I think my problem was caused by an old injury being aggravated by a crease in my very soft leather walking boots.

Thanks again Joshua for your valuable website.

Jan 27, 2012
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Thank you for your advice
by: Elaine

Thank you for your reply, Joshua, I will follow your advice. I have a gluten intolerance so avoid this any way. Will check the Vit D and magnesium.

The weight gain was due to a fall in 2008 when I damaged my both arms, neck and back. Unable to exercise for nearly 2 years. I am cycling when the weather permits and my new job is very active so I feel this will help.

With regard to my boots they were wellington boots that were too big for me, size 5, but due to a high arch I could not get my foot into the size 3's, my normal size.

As I was walking to keep up with my son, we were late for football practice, I had to take long fast strides almost running the boot folded at the back and dug into my leg a few inches below my calf.

The next day I noticed the lump. It could have been there before but I had no pain until I wore the boots. I had been increasing my activity levels in order to lose weight, going to zumba and other dance exercise classes but had no pain prior to wearing the boots.

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Joshua Comments:

Hi Elaine.

Yeah, even in my own experience, it's suprising how fast we can cause lasting pain by having a boot rub into the back of our Achilles.

No fun.

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Acutely painful small lump on Achilles tendon

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Acutely painful small lump on Achilles tendon