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

by tj willmon

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,



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.


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

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Nov 01, 2009
PART 2 - response to your questions - Achilles Tendonitis, what am I doing wrong that I am still feeling pain?
by: tj

Hey, this is tj. I asked these questions. Not sure if i am even doing this right, (answering the questions you asked me) So, here goes:

1. No lump; no hot spot; it hurts in different places on different days at different times; sometimes down the length of the achilles tendon; sometimes on the sides between ankle and heel; sometimes both places

2.The pain between ankle and heel: to be honest- not very sure. Hurts some right on back where achilles joins to heel. Also hurts under ankle bone in the softer area between it and side of heel.

3. Calves and soleus do feel tight at times. No knots, though.

4. I have never had pain in achilles or heel before. My feet? Well, they just ache a lot. They always have. Really hurt in mornings and at night; just an achey hurt though. No sharp pains or anything

5.Health issues? Everything good I guess. I have a very "nervous" stomache. Gets upset a lot (my dad is the same)

6. No spasms or twitching

7. Haven't had shin splints since high school

8. Not sure how "friend" diagnosed the tendonitis. He asked me a lot of questions, poked all around, and had me push and pull against his hand, ect..

Thanks again,

Nov 09, 2009
PART 3 - Achilles Tendonitis, what am I doing wrong that I am still feeling pain?
by: The Tendonitis Expert

Joshua Comments:

Hey TJ.

I can't believe I didn't ask you how much/often you did/do/want to wear high heels.

It's GREAT that you have no lump or hot spot, though that does make specific identification a bit tougher.

But you have a history of a lot of lower leg athletic use. This tightens everything up.

You have a history of sore achey feet, which points to a long term Process of Inflammation.

Combine lots of use with increased tightness and inflammation and presto, you get a Pain Causing Dynamic.

Years pass, things continue to get tight and more painful (whether you feel it or not) and then one day you overstretch, or overstrain, or just frighten your nervous system (like tropming around unfamiliar terrain in high heeled boots) and your ns panics and kicks in measure to protect you.

That mechanism, unfortunately, has you hurt more so you move less so you won't injure yourelf.

HOPEFULLY your pain is an overactive Inflammation response that is now overpowering your body's attempts to settle everything down.

Nothing surprising to me about your situation.

Maybe you have some Tendonitis or Tendonsis going on, maybe your structure is just constantly being flooded with pain enhancing chemical from inflammation.

Either way, you need to deal with the muscle tightness, the constrictive connective tissue, and the inflammation.

My top suggestion is that you get 'The Plantar Fasciitis Treatment That Works', and I'll show you how to adjust that to include your calves, soleus, and lower leg.

Other than that, learn How To Reduce Inflammation

See what happens with upping your Magnesium levels.

Can't hurt to make sure your Vitamin D levels are within range. One of the symptoms of Vitamin D deficiency (and most everyone is) is pain. That could be playing a role.

Also, you asked 'what am I doing wrong that I am still feeling pain?'

Also can't believe I didn't follow up on that. Other than the boot and rest, what have you done for it that you would expect results from.

Jan 22, 2013
Acute Achilles tendenitous 10months free accident
by: Rebecca

My friend reversed his 500hp ute into my foot a week before Xmas (10months ago), it blew up and bruised, I was on crutches for a month as I worked right thru (in an office).

I drive a manual car myself which i returned to driving a couple of months after, which has probably strung the recovery out

I've had pains under the heel shooting up&weak pains up to my knee, it always aches and feels weak, but now my ankle gets a hot sensation that concerns me. It is still swollen and I still have bruise type marks arching over my heel, it's so sore to touch at the Achilles and the outside of the ankle.

I have gone back to my physio who wants me to fork out to get orthotics.

Any advice welcomed with reference to the hot sensation.


Joshua Comments:

Hi Rebecca.

You're still bruised 10 months later?

That's not ideal. It may or may not be a problem.

Burning sensation comes from the pain enhancing chemical of Inflammation, or nutritional issues, or blood clots (possibly).

I'm assuming that since you've seen a doctor blood clot has been ruled out. But I do not assume they've ruled out nutritional lack affecting the muscle and connective tissue function, and pain enhancing chemical isn't on their radar.

I'd need to more about the specifics of the accident and what's happened since then.

Tell me more, and give me an update on how things are now since you submitted your question.

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