Achilles pain getting me down - will it ever go away?

Bones, joints and muscles
1

Hello

Brief background: I'm a 45 year old female with a six month history of right foot pain. This started out as top of foot pain but has changed to achilles pain. An MRI in May has shown that I have some mild achilles tendinopathy and I was referred to a physio who has shown me calf stretches and the protocol for eccentric exercises. I'm not a runner(nor a big exerciser) which is why I'm puzzled as to what has caused this. I have put on some weight recently and and have been told that I am flat footed in both feet. I have had orthotics made at great expense but as it is summer it's hard to wear them. The podiatrist recommended Fit Flops which I do wear but the pain that I experience is bizarre and I wondered if this is normal?

I wake every morning with a stiff and sore right achilles. I also have pain under my foot towards where the outside toes join the foot that goes away after a while. Originally the achilles pain would come and go but now it's here almost all the time. Sometimes I press the tendon and it hurts, but other times it does not hurt, or at least not as much. I iced the tendon earlier and I was in so much pain that I thought I would be sick. 20 minutes later it was as if I had no problem at all. If I stand for any length of time I get shooting pains up the back of my calf. If I walk anywhere for too long I get a similar pain. I find the exercises have almost made it worse. I also find it hard to do single leg calf raises - the back of the leg above the heel feels stiff and painful.

Is it normal to get on off pain with achilles in the space of 20 minutes? One minute I'm wanting to scream, the next it's OK. I find myself changing shoes about 4 times a day to accommodate the pain! Will this pain ever go / settle? I'm so depressed.

Any advice or help is much appreciated.

Thanks

 

2

Hi TLM

Really sorry you're having this trouble/pain in your feet and Achilles Tendons.

Because you say you can't understand what has caused this, as you are not a runner or have exercised in any way to bring this on, I wonder if you have taken any antibiotics from the Fluoroquinolone class, in the last year? This type of antibiotic, eg., Ciprofloxacin, Levofloxacin, Avelox etc., can cause Adverse Reactions, such as Tendon problems, in particular  Achilles Tendon damage and a range of Tendinopathies, which can lead to rupture. These ADRs can be delayed and only manifest weeks, months or longer, after stopping this medication and often occur in people who have no prior history of this kind of problem.

Plodding on

3

Hello, thanks so much for your reply. No antibiotics that would have caused this. All I can think of is I have been doing quite a few calf raises etc over the last year to get rid of my flabby calves and I'm wondering if this is what has caused it?

It's the bizarreness of the pain. I also now have a bump just above my heel which is painful to touch. The exercises seem to aggravate it. The podiatrist is telling me it's due to my flat feet but why now?

4

Ok. Not due to antibiotics then. It was just a thought because Levofloxacin caused me to be bedridden for nearly 6 months with Achilles and other tendons in both feet and ankles, being damaged and I know of literally thousands of other people to have had this Adverse reaction.

I guess it could be because of the strain on your tendons due to much stretching and calf and heel raises, along with having flat feet or fallen arches. I am not a doctor but so much pain might indicate that you are aggravating your tendons by doing too much and not allowing enough recovery time in between the exercises. Pain can be a warning sign that you  are overdoing something.

Sorry, I wish I could offer a solution but I just don't know what's happening.

I hope this resolves soon.

Plodding on.

5

Hi if you now have a lump, Google Haglands Deformity that will explain it to you... I am due to have surgery on the 27th on a heel spur and a very inflamed achelis Tendon after suffering for 3 years and trying all the alternatives. The hurting one Minute and being fine the next is exactly the same as I have experienced. I have never been a sporty person apart from enjoying walking with my dogs over the years.   

6

I'm a 41 year old female who is 4 months post Achilles Reattachment Surgery from rupturing my tendon playing tennis. I also had Bone Spurs removed. I'm still having pain on the inner side of my foot over the degradable anchor sight. Is this normal?

7

Thanks so much for the reply. This is giving me so much anxiety. I have always been active and a doer but like you say not sporty. It's so debilitating. The bump is not pronounced but it is definitely thicker and feels bigger than the left - is this what yours is like? Do you also get shooting pains up the calf? It's excruiating but then it goes as easily as it comes. The other day my leg felt "normal" and I was just beginning to think "ha this is getting better" when suddently I put a pair of different shoes on (flatter) and then bam the pain comes back, shooting calf pain, etc.

I hope your surgery goes well. Thanks again for replying

8

also does your feel like it's pinching? When my foot is flat on the ground it feels like it's pinching just a little to the side / back on the right. Do you also feel it is harder to go up on your toes?

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Hi mine started off as a small limp and gradually over the years got larger and larger. Now the whole of the back of my foot is very swollen and painful. Yes sometimes it does not hurt and. The next Second I am in agony. It feels like a razor has cut into the back of my foot above the heel. It's usually better in the morning and gets worst over the day. Also if I press my heel it is very painful. It sound like you are at the start of the problem. Go see your doctor as soon as possible, you may be able to reverse it before it gets too bad. Mine has been on going for about three years now and is irriversable. Thanks for your good wishes re the operation. Can't say I am looking forward to it, I had a bungion operation done on the other foot in February that I am still getting over xx

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Thanks Swapiesue,

I don;t have a classic bump that's visible - just a thickening at the back.

What concerns me is the way that I will get shooting pains up my calf too - is this normal? It's so bizarre. Some days I hardly notice it and others the pain is dreadful with pain all the way up my lower leg. It's not just restricted to the heel area. Is this common with achilles problems?

Thanks

11

Yes it is the same as me, it can even change within a few moments ..

12

Hi TLM, sorry to hear about your ankle and foot pains, the issues you have described are very similar to my experiences and I know there is hope so be positive.

 I think you are right to question why your pain is happening and have already realised there’s no singular magic cure (insoles/ medication/ stretches), but understand that there are practices and procedures in place to attempt to: address, tackle, alleviate the issues.

The body is a complex thing physically one issue can affect another, what was interesting was the original toe/ upper foot issues you described (been there). A lot of the issues are created by a sufferer trying to compensate for their pain, biomechanics are thrown out of balance and the result is pain somewhere else…….the route of mine was, I believe, tight hamstrings, thigh and calf muscles/ poor stance which in turn meant a funny walk not wanting to stride “normally”.

So orthotics are made to work with the wearer, to support them but not fight against them in reprogramming stance/ walk

Physio is given to stretch and strengthen (address muscular in balance) and aid recovery and push through the pain in a controlled and non gung ho manner (ouch for single legged stair drops !!)

Medication is given to relieve the inflammation and manage the pain, but remember we are talking nerves here…meds only have limited effect

The flash stabby shooting (in my case also hot burning) pains you are experiencing are “normal” but it is not mild achilles tendinopathy. Do not accept this description TLM. The weirdness in how it comes and goes is “normal”, the pain and stiffness you experience in the morning is “normal” for the condition but not acceptable. My question was why I could stand on my feet or ages yet almost be in tears when sat in my car after work, why I could ride a push bike hard for 30 miles with no issues

My advice, get bigger shoes lose a bit...... but don’t worry too much about the weight ( weight is weight….sore ankles are sore regardless) carry on with the program maybe enquire after a thermoplastic formed night splint from the NHS and give it a go for a few weeks…….ultimately give your regieme  a year at most, the area we are talking about is very slow to recover, if it does not improve…..surgery

 

My Pain CV

Experience: 16 years Bilateral Chronic Achilles issues, working up to 12 hours a day on the feet from hell. Boxes and boxes of ParaPrufren cocktails, including overdosed levels,  all of the gels (best is ibuleve max strength), TENS and EMS machine, enough ice to sink the titanic, frozen pea compresses, so many stretches and so much time doing it, god knows how many different insoles including shiny carbon fibre ones with 3mm of rubber beds, leg brace/ night splint (quite good), gait and stride analysis, umpteens physiotherapists and podiatrists in the end last year 1 physio who listened 2 x-rays, 2 massive broken heel spurs found (felt one of them break off….ouch that hurt), 6 week wait on the NHS 2 Achilles Decompression operations in 6 months, physio again, and now have a private physio for fine tuning.

Current status:  6 months after last operation, little or no scarring, and I’m now at 90% fixed with no burning stabby pains just occasional tenderness to the sides of both calcanium which can be stretched out, and a little stiff in the morning but great when on holiday, little or no meds which work in 30 mins and am pretty awesome on a bike again, ok on my feet at work…not bad when last year I had to spend most of the weekend with feet on frozen peas and lots of paraprufren and ibuleve and was borderline having to quit my job

Future: put all this behind me and have fun but hopefully help someone else through it first :-)

I hope this can be of some help

 

 

 

 

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Thank you SOOOOOOO MUCH! You have no idea how much this reassures me. I have health anxiety as well and have been twitching all over for nearly 2 years. I have been to see a very highly regarded neurologist and I had an EMG about 18 months ago that was clean with not even a fasciculation showing so he could not give me a BFS diagnosis (benign fasciculation syndrome). I came away frustrated but relieved.

As you can appreciate it is these twitching symptoms coupled with the ongoing muscular issues that have me living in fear most of the time that I have MND. I have been to my GP who tries to reassure me that I am fine (reflexes are normal etc and no weakness as far as he or I can see). The physio exercises that I was shown made the pain worse and what has made me rather anxious are the single leg ones that push up from below the stair - is it normal to feel weaker in the leg with the afflicted achilles?

I have been wearing my custom made insoles in a pair of Karrimor trainers and funnily enough the pain diminishes. On holiday recently I wore another pair of trainers not these with the insoles in plus Birkenstocks / fit flops when too hot for trainers. My achilles was so painful and even the left one started to hurt. I am now back from holiday and have now switched back to my other ones and have taken to wearing them all day even in the house which I hate but the achilles has settled down again.

When my kids go back to school I am going to go and see a sports physio and really try to get this sorted. When I massage my soleus it screams and I think that I may have weak hips as when I bend down my kness do not go parallel but are slightly turned inwards.

Once again thank you for answering my questions. So many forums are all about runners who have this and I am not a runner which is why I have been so anxious. When reading it is hard to find places that say it is normal for non athletes to get this!

14

Hi again TLM, single leg stair raises are a crazy exercise...it also seems that if if you have a soleus issue it might aggravate it further (see link) I actually refused to do this exercise when asked post operation, I simply knew I couldn't do it without aggravation. FYI I have had no solleus issues.

I found this on the net this morning, it might be of use. http://www.massagetherapy.com/articles/index.php/article_id/2035/Soleus-Muscle-Strain

With regards to weaker in the leg pre-op , I can't really say I noticed it, however as I have aged I have started to lose muscle and also lost some mass during rehab due to inactivity (i have a very physical job), it's more likely you are more sensitive to the pains and fears and so just treating your "dodgy" leg more timidly.

Many people's knees bend in, again it could be from the feet being flat, or maybe a core issue in the lower back.....but I'm no physio. Ultimately bio mechanical issues manifest themselves in weird ways, it's all linked and quite a complex chain, I've had some very odd aches during my rehab, a good physio who listens will help....the bottom line is there's a he'll of a lot of tension pulling On your Achilles, more so when your body is out of tune.

15

Thank you for your description of the pain and your out come after surgery... I go in to hospital tomorrow all being well and your answer has reassured me.. 3 years I have suffered this pain and it's really getting me down now.. X

16

Good luck tomorrow and with your recovery. I definitely think having surgery was the best thing I ever did , even with Only being 90% fit I'm so much happier than before.

A couple of bits of advice if I may.....

Enjoy the day, revovery starts now.

Beat that swelling post surgery.......Keep that foot elevated as much as possible for the first couple of weeks when not in use, lots of pillows and own that sofa, raise newly fixed foot in bed wear those surgical stockings every day till at least physio appointment 1/ your surgeon says no need. Drink loads of water afterwards, seriously, I mean loads, I was so dehydrated.....it's ok to hobble to the loo, maybe get a stewee...(i used a bottle but its a man thing!).

your leg and foot should NOT hurt badly and should not swell massively...if worried Contact your team.

From day 1 do micro raises with your soon to be awesome foot, by that I mean when lay down watching lots of tv etc, and just gently and regularly rock the ankle forward and backwards to stretch and release the tendon, wiggle those piggies too as this aids circulation . Take your time crutching around, take your time on stairs. Do not drive till cleared by team. Try to gauge mobility, don't do too little.....especially after say 7 days, just potter around then rest with raised foot for a bit. Do not expect too much, too soon, walking round Asda is like a marathon to a newly fixed leg and so consider that bad juju and uneven ground like fields or even kerb drooppers for driveways are awkward. I'm sure you have sorted your meds, I did well on paraprufren cocktail.

Best physio exercises are controlled slowly walking heel to toe (it's a balance and slow stretch) and standing and balancing on newly fixed foot (best after a month or so).

Get your hubby, kiddies, minions etc to do your evil/ good bidding for a few days....Enjoy the attention, you deserve it

Recovery starts here :-) good luck again...don't be scared,enjoy the day.

17

Thank you for the good wishes and advice... X

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How did your surgery go?

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Hi Unhappy feet, it's early day yet as you know, I am in a back slab plaster cast and walking a little on one leg with a frame. I found my arms a bit weak for the crutches at this stage. Although I mastered jumping up the small step at the hospital I found the entry to my Bungalow a lot higher and and to get in using the stall I was given for washing. I sat on it and my husband dragged me back.. I looked a right sight I can tell you. So far I have not mastered going out yet but I will have to find a way because I have my first appointment with the Consultant on Monday 11days after surgery. I am not in pain as such but the scar under my plaster feels a bit sore at times. I woke me a couple of times and it is for that reason only I still take one dose of morphine a day at night.. The main aches and pains at the moment are from all that sitting around.. I am on blood thinning injections everyday for the next six weeks which I have to administer myself and are no way as frightening as you expect them to be. How long was it before you were able to weight bear ? This hopping around is killing me, although I guess it will be a while yet. 

20

Hi swampiesue, it sounds like everything is going really well, I'm very impressed with the self administration of your meds.....very brave. I too struggled to Get in home, I found a HALF slab supported on loose bricks worked and used it as an extra step. Try not to hop, it's kind of dangerous, you want to be careful not to strain your better leg while you wait for your fixed one to become strong, I kind of shuffled or half stepped and bore partial weight but used crutches or cruised using furniture to take the brunt of the force

I stopped using one crutches at maybe 10 days except for stairs and distance work, and handed them both back at maybe 8 weeks but kept a stick in my car just in case.

I forgot to mention I used a satchel like bag to move all my shiny stuff, books and meds and water round the house with me, washing was done in the d/s loo untill I could shower, I used clung film to keep my dressings dry....ish when showering later but tbh it was a poor attempt at waterproofing.

The ache on your scar seems normal, I had it, it will let you know when it's had enough as you continue to get better. Remember to beep stretching your leg out and paddling your foot and wiggling those piggies , it helps the blood flow and so aids recovery and movement. Just be aware of any bad pain in your calves or knees pot thighs and act if you are concerned

I think you will be impressed with your scaring when you see your consultant, mine has now almost gone at 1 yo and the 6 m o one isjust a touch achey and almost scar free, but as I mentioned I do push mine quite hard (48 hours on my feet in 4 days) that's some huge improvements over last year....give it time (there are occasionally dark days when you question is it fixing or how long will it take) but, you will know with patience and perseverance it's one of he best decisions you've ever made.

Take care