pain behind achilles

[stuffedolive]

Hi,
I am a 50 yr old ex cyclist and now an orienteer. For some years after converting from cycling to running I suffered periodic calf strains and minor achilles tears, these have reduced in frequency as I became a more seasoned runner and better at diagnosing and treating injuries. I have been well cared for by a super sports masseuse, a podiatrist and my dad (an ex top level 880yds man) who draws on a wealth of effective old-fashioned cures.

However my latest injury just will not respond to any treatment. 10 weeks ago I finished an event with a sore achilles. This used to happen a lot but not in the last couple of years and was invariably referred pain fron a calf strain. My only memory of pain during the event was landing on a large stone before my foot was ready to make contact with the ground, which was momentarily very painful.
Initially it was treated as referred pain from the calf - lots of massage & stretching, but it took a while (2 weeks ) to ease up then pain started again as soon as I restarted running (offroad of course).

Over the succeding weeks it was very painfull to stretch the calf/achilles and any improvement was soon undone with even gentle activity (eg shopping!). The pain on stretching is experienced , not in the achilles itself, but between the achilles and the ankle bones - very curious and not something I have experienced before.

After all these weeks of rest and treatment, I managed one painfree jog a couple of weeks ago, followed by several days of painfee stretching and walking. But then the pain started up again, for no apparent reason.
As rest does not seem to be a cure, I have since decided to try to continue running (at a low level and not uphill if I can help it) as much as I can - icing the achilles after each run and taking a days rest before going out again. I seem to be able to manage this but there is sufficient soreness at the end of each run to indicate that I am unlikely to be able to progress beyond this level.
Any ideas anyone? Could landing on a stone have damaged something else? if so what?

[Ruth]

Hi,

Landing on the stone could possibly have caused some bruising to the underside of the foot but I wouldn't have thought that would refer upwards into the achiles - may be worth considering?

If you really thumped down on the stone, perhaps you might have damaged or irritated one of the small bones in your foot, or the larger bones in the ankle? Was there any swelling after the run at all? This might explain why the pain isn't coming from the achiles as you described.

Did you roll on your ankle at all when you stood on the stone?

If this is concerning you and is affecting your running as much as it seems to be, I would certainly suggest getting checked out by a doctor and if possible see if they can do any scans to check and see if there are any problems going on in the ankle/foot itself.

[stuffedolive]

Ruth,
thanks for the reply.

My memory of landing on the stone was that I didnt roll my ankle (although this is the same foot that suffered a very bad sprain a few years ago and has never recovered its full fore/aft flexibility), rather I think I landed in such a way that my foot was either pushed up towards my shin, or the other way around - sorry I can't remember, it's all pretty hazy as I was concentrating hard on my map, and I ran off the initial pain within 30secs or so.

There was never anyquestion of bruising to the foot bones as I suffered no pain at all apart from around back of the achilles just above the heel bone where there was a bit of swelling. An aquaintance suggested 'dancers heel' but I dont know much about that.

I have seen a GP and am still awaiting an appointment for a physio investigation, however that process could take months as their attaitude is always 'what do you expect at your age - be grateful you can run at all'!

thanks
Mandy

[Ruth]

Hi,

Dancer's Heel is another term for Posterior Impingement Syndrome which you can read about here: http://www.med.nyu.edu/hjd/harkness/patients/injuries/foot.html#posterior

It might be contributing to your symptoms however I would wait to see what comes of the appointments!