Achilles Tendonitis, what am I doing wrong that I am still feeling pain?

by tj willmon
(lufkin,tx)

I am 40 years old and have been a runner since high school (low mileage, 3-4 miles at a time).

Have also been teaching all types of aerobics classes for 18 years.

I am very careful to warmup and stretch properly.

I have never experienced injury in my achilles tendon.

However, exactly one year ago I started feeling pain in my left foot. It ran down the inside of my ankle between the ankle bone and heel. It eventually went to the other side as well and all way up the soleus and achilles tendon.

I tried to lay off and rest. Then (and this may sound silly) my whole family of 18 had a family picture taken in a park. I wore high heeled boots. We tromped all over the park and down into a creek for the picture. It hurt so bad my husband had to carry me out of the creek.

From that day on, it was worse. I finally went to a orthopedic surgeon "friend". He diagnosed it as tendonitis (which is what I thought. But I told him let's do some aggressive treatment, so I had it casted for 5 weeks.

It was weird because I could still feel it hurting in the cast, especially when he told me to walk on it some.

I finally used crutches and it helped. I took it easy when I got out of the cast and gradually built back up.

I have been pain free for about 4 months now.

During this entire last year I did not wear any kind of high heel shoe, afraid of re-injury.

Friday night I wore a mid-heeled boot and now I am hurting again!

This is not muscle soreness from working a muscle. This feels like it did a year ago.

What is going on with the "high heel shoe" thing? Please don't tell me I can never wear high heels again! (Of course, exercising and remaining pain free IS more important!)

Is there something else that could be going on? (oh, and by the way, we did not have an MRI done)

Hope you have something to help me out!

Thanks a bunch,

TJ



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Joshua Answers:

Hi TJ. Thanks for the long description. That saves a lot of time back and forth.

My first reaction to you casting your ankle for 5 weeks was "OUCH!" But hey, if it got you out of pain for 4 months, maybe that's not all bad.

But it clearly didn't heal the problem, which is my main complaint about immobilization.


Let's talk for a moment about the concept of 're-injuring' the Achilles tendon.

If you mean 'injure it more', ok.

But if you mean 'it healed and now it's injured again', that may not be the best way to think about it.

You aren't re-injuring it, in the sense that it was healed in the first place. Just because there is not pain doesn't mean that there isn't a problem, or at least a problem already in place just waiting to get triggered.

It's alreay injured because you have Achilles Tendonosis.

Or, if it is true Tendonitis, it heals back less structurally strong, and you're really just re-irritating it by popping off a few weak fibres of scar tissue. Then the nervous system amps up the pain response.


Let me ask a few questions before I go making statements about what you have going on and why.


Questions:


1. If you poke around on the Achilles Tendon, is there a lump? A hot spot? Does the whole thing hurt or just spots of it?


2. That pain between ankle and heel, say a little more about that. A tendon on the ankle, or the tissue between the bone and the Achilles was hurting?


3. If you poke around your calves and soleus, do they hurt? Are there tight knots of painful muscle? Is the whole thing tight? How tight?


4. Have you ever had -any- amount of pain in the calves/achilles/feet?


5. Any other health issues? How's your digestion?


6. Any spasm or twitch going on?


7. Had shin splints before?


8. What were the criteria your 'friend' used to diagnose Tendonitis?


I have a theory on why the high heels sets this off, but let me see answers to the above questions first.





Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com