Achilles Tendonitis at the Insertion to the Heel

I searched and found very little on this.

Backstory. Grew up in a non snow state. Skateboarded bowls and half pipe at a high level from a very young age. Surfed at about the same level too. While skateboarding ran out of many bails (no knee pads) always coming down on the right heel with crazy heel bruises. Wash rinse repeat 50,000 times. Fast forward to about 15 years ago. Move to the snow, start snowboarding. Get good quick with a really surfy back foot (r foot) style. Never slow down skateboarding. Move to Utah, snowboard and skate even more. Have kids, slow down and get fat but still keep the high level. R heel develops a big knot on the back, running out of bails causes days to weeks to months of pain. Switch to skiing with my kids, not skating much any more, Heel pain goes away, knot still there. Boy starts skateboarding, I'm at the skatepark 5X a week with him charging hard to impress the younguns. Heel pain becomes unbearable. Walking, ouch. Walking up stairs, ouch. Bump it on something FUCKING OWWWWW!!!! Go to several ortho's and podiatrists they diagnose achilles tendonitis at the insertion in the heel. I can't skate any more, can't ride a bike, can't run. I can still ski but BC touring kills with the repeated ankle flexing so that's out. I'm doing a lot of fishing and drinking but it is not filling the hole left in my somewhat active lifestyle. I have decided surgery is the probably the best option. Surgically remove the tendon at the heel bone. Clean up all the scar tissue, inflamation and remove the now huge bulge. Reattach and "bleed" the area to get some type of cartilage like regrowth since this will mostly be removed. 8-12 months before 100% or as close to that as I will ever be. FML!

Questions....
Anyone had this particular form of Achilles Tendonitis?
Were you able to remedy it via PT? What PT did you use?
Did you do surgery and what were your results?
How fucked am I?
Any opinions on Dr Troy Gorman with IHC in Salt Lake City?

Thanks Maggots. +++vibes+++ are appreciated...

Shoot me a PM. Been dealing with this for 6 years.

Long story short, you will not ever be 100% what you were, but it should be manageable without surgery unless you rupture. Achilles tendonitis is like herpes, you probably have it for life, or will be very susceptible to it recurring in the future.

Thanks adironrider pm sent.

Drs (multiple) say I am high risk for rupture and surprised it hasn't happened yet and throw the flag that a surgical induced rupture (controlled clean cut) and insertion cleanup is much easier to successfully recover from than an activity induced rupture (uncontrolled, jagged cut, shortening of tendon, heavy bleeding, trauma). My touring days are down from over 30 days to only a couple days last season with days of riced recovery after. The ones I do are not far out of sight of the car, which isnt too hard in the wahsnatch but still.... backed out of both a yurt and a Japow trip. fuk!

Getting old fucking sucks. [emoji88]

I had tendonopathy in the Achilles, right at my heel, last year for 6 months or so. Its still not 100%, but close enough.

It was terrible at first. Walking was doable, but painful. Couldnt run, only elliptiqueen machine. Skiing was painful, and absolutely dreadful.. I found out it was my ski boot that caused it, so I switched boots a month in, and it started healing. Still it lagged for 5 more months before it was near normal again.

I found walking a ton and doing calf raises super slow with your toes on a ledge really helped. Strengthen the entire range of motion for the muscles from your knee to your heel. Also, stretch the hamstrings, calves and the muscle right below the calf, but not too much. Like hold 1-2 minutes each leg, every day, is good. Too much will snap shit up. A

I would try prp injections before surgery, I had them for elbow tendinitis add plantar fasciitis and both are completely healed.

Btw, why are you high risk to rupture your tendon?

I had tendonitis and still have it, yet I have recently been able to manage it in spite of a heavy training load and it's getting better.

I changed a bunch of things that I think led to a major improvement, but I think this was one of them:

http://www.tensunits.com/product/DI3717.html

30 minutes after heavy workouts in EMS mode. Sounds cheezy, but I think it works and helps increase blood flow.

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Originally Posted by rod9301

I would try prp injections before surgery, I had them for elbow tendinitis add plantar fasciitis and both are completely healed.

Btw, why are you high risk to rupture your tendon?

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Dr's say that the high level of inflammation and the amount of impact I take its gonna happen. Not sure if they are trying to sell me on the surgery though. Forgot to say I have been taking meloxicam which is an anti-inflammatory daily for several years to treat this. Starting to worry about the kidneys. I am looking into the prp, seems promising. The calf raises and stretching are daily for me with no improvement. Meet with Gorman on the 27th. I do not want to go under the knife if at all possible. Going to get an estim machine too.

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Originally Posted by csorthofeet

I am on my feet all day and by evening they are hurting and suffering from achilles tendon pain.Thanks to Orthofeet shoes, I am still breaking them in but pain is decreasing. My feet feel snug and supported. The arch support is very noticeable and feels good. Will be trying sandals also. orthofeet sneakers felt great as soon as i put them on. I am walking several miles a day and even started running some.

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#SpamBot

Spam bump

Still living with AT at the insertion. Was going to go under the knife a year ago but quit my job and skied 120 days. Got a good job now probably going to schedule the surgery end of april. Got a bird pass this year so maybe a bit longer lol

Oh and 15mG of mobic daily is very helpful

I replied to you years ago in this thread, now that I've got another three years since I had my partial rupture the tendonitis is pretty much non existent, or at least what I called like herpes has been in remission for a couple years now.

I forget, have you had any prolonged breaks from physical activity? Totally anecdotal, but I got chained to a desk for work a couple years back for like 2 months straight and did basically zero physical activity. Seemed to be the trick for me by forcing me to rest it completely. Worth a shot before you guarantee yourself a year of downtime basically with surgery.

Downtime is impossible my job has me on my feet. The knot on the back of my heel is hudge. Ive gotten my activity back up by avoiding the stuff that really hurts which is skateboarding and snowboarding. Bought a bike and it hasnt killed my foot. The 4 docs Ive seen on this say I have a severe case but it has at least been managanle the last little bit.

My ortho seemed to think the knot indicated a partial tear, but she did combine that with an MRI before making that diagnosis, it's also been a while now.

Just be prepared, if you need to be on your feet for work, I hope you have a dope medical leave/vaca/sick time package at work, because you aren't going to be able to do it for I'd say 2-3 months at a minimum.

Best of luck, I'd still go with the management route personally, but I made that tradeoff and supposedly am just going to rupture when I'm older.

Welp... bummer bump....

5 th time down The Whole Enchilada about 20 miles in a good ways past the last bailout I took a 4 foot drop to flat way too slow did everything wrong and should have gone OTB but saved it. Bucking off a bottomed out fork onto the rear wheel made my heel come down hard and strain/mild tear achilles at the insertion. Fuck. The pedal out was pure pain cave. Hike a bikes down to the CO were extra brutal. Podiatrist sez month in a boot and you should be able to ski. If not itll be a 900 inch season in the satch.

And a puppy because she makes me happy...


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+++vibes+++. just saw this thread searching for new answers. i've had this for over 20 years now. i just do the stretch/ice/ibu method when it gets painful. heat on my feet while sleeping also improves it. and pay attention to never sit with your heels touching the floor, like at an office desk, or propping your feet up while on the sofa, and while driving. i have a leg support cushion for my couch surfing that allows me to hang my feet off the end, eliminating any heel contact. good luck!

edit: and shoes. basically i am fucked for any low top sneakers any more. the rubbing kills. birkenstock cork inserts in all my shoes. birkenstocks are super comfy and relieve the stress too. i even wear them to work. with socks sometimes.

Got my boot off last week and still have some pain when I load up the toes to push off of them but that is getting better. Think that I should be able to ski.

Yessir Ripz you know the pain. I got mine pushing a skateboard and turning a skate, surf or snowboard for 30 years and have been dealing with it for at least 10 years. Not a day goes by that I am not in pain from this. The knot (Haglund's Deformity) was bad before but now it fucking kills if anything touches / rubs it. Certain shoes really fuck with it. I have some nike slip on sandals that I wear to work because I change into scrubs and wear steel toes. Just put heel riser inserts in my work shoes and my vans. They make a hudge difference. I have been on a heavy prescription anti inflammatory (Mobic) for years for this thing if I miss a dose it is limpy time. Going to hit the bootfitter for him to give me a little more room around the haglund for this season. Then it's Insertional Achilles full thickness dissection, bursa and bone spur debridement and smoothing then surgical reattachment in the spring. Hopefully turn it all the way around and be ready for next ski season. If so I am buying a new set of boots!

Hey Ripz now you are an official member of TTT-The Titusville Tendon Tearers! Or Terriers.... Or Whatever..... LOL!

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I’ve been dealing with this for several years now. I ended up with a massive knot right in the middle of both of my Achilles tendon.

In the end I decided not to have the reconstruction surgery on the tendon itself. Tendons take a very long time to heal. They do not grow well, and they do not stretch well. My doctor thought that by the time they removed all of the damage tissue, that they would not be enough tendon left to vent it from snapping on its own.

My doctor thought that my problem was caused by a structural issue. My muscles were simply not long enough for my skeleton. He thought that the problem had been going on my whole life and I was just seeing the tipping point now.

So what he did was a gastroc recession. Basically, he went into the meat of the gastroc muscle above the Achilles tendon and made a series of slices that were not sutured afterwards. That allowed the muscle to spread out and become longer than it was before. That in turn reduced the strain on the Achilles tendon.

I had the surgery just about two years ago. Both legs had to be done. I had them done about two weeks apart. I was recovered enough from the first one to hobble around on crutches after the second one. Since the surgeries, I have seen steady improvement in both legs. The knot on the right leg has almost disappeared completely, and I never have any pain in that tendon anymore. Left tendon has taken a little bit longer because it was in worse shape in the first place.

I don’t know if this would work for you or not, but it probably would be worth looking into.


Here are some links to a few case studies you may be interested in.


https://www.ncbi.nlm.nih.gov/m/pubmed/28413894/

http://www.aofas.org/footcaremd/trea...ocedure)-.aspx

https://www.healio.com/orthopedics/f...leus-recession

https://journals.lww.com/jbjsjournal...chilles.2.aspx


Good luck man, I hope you find some relief.

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Originally Posted by m2711c

I’ve been dealing with this for several years now. I ended up with a massive knot right in the middle of both of my Achilles tendon.

In the end I decided not to have the reconstruction surgery on the tendon itself. Tendons take a very long time to heal. They do not grow well, and they do not stretch well. My doctor thought that by the time they removed all of the damage tissue, that they would not be enough tendon left to vent it from snapping on its own.

My doctor thought that my problem was caused by a structural issue. My muscles were simply not long enough for my skeleton. He thought that the problem had been going on my whole life and I was just seeing the tipping point now.

So what he did was a gastroc recession. Basically, he went into the meat of the gastroc muscle above the Achilles tendon and made a series of slices that were not sutured afterwards. That allowed the muscle to spread out and become longer than it was before. That in turn reduced the strain on the Achilles tendon.

I had the surgery just about two years ago. Both legs had to be done. I had them done about two weeks apart. I was recovered enough from the first one to hobble around on crutches after the second one. Since the surgeries, I have seen steady improvement in both legs. The knot on the right leg has almost disappeared completely, and I never have any pain in that tendon anymore. Left tendon has taken a little bit longer because it was in worse shape in the first place.

I don’t know if this would work for you or not, but it probably would be worth looking into.


Here are some links to a few case studies you may be interested in.


https://www.ncbi.nlm.nih.gov/m/pubmed/28413894/

http://www.aofas.org/footcaremd/trea...ocedure)-.aspx

https://www.healio.com/orthopedics/f...leus-recession

https://journals.lww.com/jbjsjournal...chilles.2.aspx


Good luck man, I hope you find some relief.

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That's cool that you have relief. My deal is at the other end of the tendon where it becomes part of the heel bone. I don't have any thickening in the tendon body itself. It's from repeated traumatic flexion of the ankle that pulls the tendon tight over the bursa at the back of the heel. Irritates the bursa and the tendon. I have a couple bone spurs and some deformity in the upper corner of the heelbone which is fucking up the whole shebang even worse. According to the podiatrist the deformity is from broken heelbone.

I bet your recovery was quick. I am looking at 4 to 6 months before weight bearing.....:the_finge

That is after this ski season and hopefully healed in time for us in 2019-2020 ski season

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Originally Posted by TheFugitive

Got my boot off last week and still have some pain when I load up the toes to push off of them but that is getting better. Think that I should be able to ski.

Yessir Ripz you know the pain. I got mine pushing a skateboard and turning a skate, surf or snowboard for 30 years and have been dealing with it for at least 10 years. Not a day goes by that I am not in pain from this. The knot (Haglund's Deformity) was bad before but now it fucking kills if anything touches / rubs it. Certain shoes really fuck with it. I have some nike slip on sandals that I wear to work because I change into scrubs and wear steel toes. Just put heel riser inserts in my work shoes and my vans. They make a hudge difference. I have been on a heavy prescription anti inflammatory (Mobic) for years for this thing if I miss a dose it is limpy time. Going to hit the bootfitter for him to give me a little more room around the haglund for this season. Then it's Insertional Achilles full thickness dissection, bursa and bone spur debridement and smoothing then surgical reattachment in the spring. Hopefully turn it all the way around and be ready for next ski season. If so I am buying a new set of boots!

Hey Ripz now you are an official member of TTT-The Titusville Tendon Tearers! Or Terriers.... Or Whatever..... LOL!

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man, those are some guh-narly pics in the link. good thing i just finished my lunch. i have that haglund deformity too. i have huge bumps on the back of both feet. i thought they were just normal for the longest time. and bursitis in that area, which i guess i have too. i had severe heel spur pain about 25 years ago, did the surgery on one foot, it did nothing to relieve the pain so i bailed on doing the other foot. then eventually after a couple of years it just went away in both feet. maybe the shoe inserts helped over time. i used superfeet in my normal shoes for year before discovering the birkenstock cork inserts. and then just about 5 or 6 years ago, i had quadruple bunionectomy surgery. that was amazingly successful. the last ski season before the surgery was the most painful thing. that last lap down to the road and the walk out in boots KILLED.

TTT crew - so we need to find a way to ski together someday! i'll be in tville over the christmas holidays if you are around.

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Originally Posted by Ripzalot

man, those are some guh-narly pics in the link. good thing i just finished my lunch. i have that haglund deformity too. i have huge bumps on the back of both feet. i thought they were just normal for the longest time. and bursitis in that area, which i guess i have too. i had severe heel spur pain about 25 years ago, did the surgery on one foot, it did nothing to relieve the pain so i bailed on doing the other foot. then eventually after a couple of years it just went away in both feet. maybe the shoe inserts helped over time. i used superfeet in my normal shoes for year before discovering the birkenstock cork inserts. and then just about 5 or 6 years ago, i had quadruple bunionectomy surgery. that was amazingly successful. the last ski season before the surgery was the most painful thing. that last lap down to the road and the walk out in boots KILLED.

TTT crew - so we need to find a way to ski together someday! i'll be in tville over the christmas holidays if you are around.

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Yeah man fucked up landing gear make everything a pain. When every step hurts shit gets real real quick. They say achilles tendon pain is one of the worst. At least that's what I'm saying....

TTT crew- I was just back there for a funeral, ended up drunk on MD and JD slapping ass at Cheaters in CC. Funny how the ville will do that to you. Had my fill of for a while, it don't take much. I ski on the reg here with a guy from satellite beach, another from winter park and another from fort laudy. They are all like "you're from Titusville? what a shithole...." If you ever ski in Murica head Utah way I got your hookup. My company is buying equipment from a Swiss company so there is a chance I may be out that way for some training in the future if so I'll bring my gear and you can show me around.

Hey, so I’m new here but have had a similar situation, not as bad as yours though. I had several micro tears on my Achilles, they wanted to do surgery on it but I’d rather avoid that at all costs. I went to PT and they would use some device to help stimulate blood flow to the area which really helped. Anytime I was feeling pain, I’d use this compression cold wrap that I had which was great as I hated finding a way to put an ice pack around the area. I also found this emr device online, so I could do the blood flow stimulation at home(saved me money from seeing PT so often). 4mons later, I’m not fully healed but it’s made a difference and i can put weight on that foot again. If you’re still contemplating surgery, rest as much as possible, put cold on when you have a lot of pain, and try to stimulate blood to the area. Really sucks with the season now, I just started skiing a couple years ago and can’t go now because of this stupid injury.

That sucks pnuts. I can live in pain but in pain and not skiing would test my meddle.

Skiing had been great until last weekend at the bird. Flat light womped a cat track going mach chicken double eject almost full yardsale. Not sure if the forward motion in eject pulled on me Achilles or slamming heel first on my first beater rotation did it but wow that shit hurt. Been icing it all week gonna ski tomorrow.

End of Season update.

Wasatch still has a fat fat snowpack but my season is done.
Got many good days but never at 100% or painfree.
Bootfitting helped but only to a point.
Touring was minimal which made me sad in the pants.
An over the bars moment fucked my deal up good a week before BBIUtard.
Skiing hard a week later with the mags when it was still hurting was a killer deal.
Haven't skied since as I still cant push off my toes without pain.

Surgery scheduled for April 11th by Dr Gorman who SFB's spancer highly recommends.
He measured my haglund in early season and then last week it is almost 10% bigger now.
He uses a small section of big toe tendon to take any tension off the Achilles during recovery.
He installs it next to the Achilles between calcaneous and ankle.
Then that gets stretched out during PT.
8 weeks disability from work with full weight bearing at 12 weeks.
Hopefully release to get after it in approx 6 months.
I am ready to get this fucking thing over with and hope for a painfree future.

Vibes dude, I hope you heal up fast. It took me closer to a year but I suspect most of that was mental. I didn't get cleared for weight bearing for 15 weeks, and still had a boot thereafter for another 6. You'll be cleared for activity at 6 months, but are going to have to build up some leg strength prior to getting after it.

The end result should be good though. I still felt some discomfort at the start of ski season for the first couple years, but now it is basically gone, and gets better every year. I am 9 years out now and barely think about it, but still do the stretches every morning religiously. They really help in my case at least and the only times I do notice the achilles, I didn't do them.

Its go time.

Measure twice cut once Dr Gorman

Good luck dude....

Good luck!

Good luck.

Been living with the tendonitis all year.. doc says I'm not in your boat yet....

Dont fall asleep at lds hospital in slc you might wake up with one of these on your pawAttachment 278153

Dr said i had about 30% attachment of achilles to the calcaneous with lots of necrotic tendon that just peeled off the bone. Hes a skier and just shook his head that i skied on it all season. He was able to clean it up to good tissue without cutting out more tendon than needed. Nerve block is wearing off a bit just took a norco? andpoked some smot so I am ready for the pain. Haha I am fucking lieing this is gonna suck for a bit!

Enjoy the spring pow utah it looks all time! You can thank me for it later

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Originally Posted by Ripzalot

+++vibes+++. just saw this thread searching for new answers. i've had this for over 20 years now. i just do the stretch/ice/ibu method when it gets painful. heat on my feet while sleeping also improves it. and pay attention to never sit with your heels touching the floor, like at an office desk, or propping your feet up while on the sofa, and while driving. i have a leg support cushion for my couch surfing that allows me to hang my feet off the end, eliminating any heel contact. good luck!

edit: and shoes. basically i am fucked for any low top sneakers any more. the rubbing kills. birkenstock cork inserts in all my shoes. birkenstocks are super comfy and relieve the stress too. i even wear them to work. with socks sometimes.

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Been dealing with mine for close to 20 years as well. Sucks immensely, but I have learned to deal with the pain and 600mg of vitamin I before each and every run. My “pump bump” on my left heel originally started from an old soccer injury. Fast fwd to today and the bottom inch of my Achilles has calcified at the insertion / attachment to heel bone. Chronic / everyday Pain has weakened my desire to run everyday and has caused a myriad of other compensation injuries. I prefer pain over being fat= only saving grace currently. My foot Dr (Christian Coetzea) says that the only real option left is to cut the Achilles off and shave off all the calcified tendon and reattach with 12 weeks of being in a boot/ no pressure. I said hell no- I’ll suffer till it goes completely then get it done. Heal up and post how your recovery goes. Prayers your way.

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Originally Posted by mn_teleswede

Been dealing with mine for close to 20 years as well. Sucks immensely, but I have learned to deal with the pain and 600mg of vitamin I before each and every run. My “pump bump” on my left heel originally started from an old soccer injury. Fast fwd to today and the bottom inch of my Achilles has calcified at the insertion / attachment to heel bone. Chronic / everyday Pain has weakened my desire to run everyday and has caused a myriad of other compensation injuries. I prefer pain over being fat= only saving grace currently. My foot Dr (Christian Coetzea) says that the only real option left is to cut the Achilles off and shave off all the calcified tendon and reattach with 12 weeks of being in a boot/ no pressure. I said hell no- I’ll suffer till it goes completely then get it done. Heal up and post how your recovery goes. Prayers your way.

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I was probably one over the bars yardsale away from getting it done early via traumatic means. The slow creep of losing all the activities you love to do has been the worst I couldnt even flyfish because due to rocky river beds. The only thing left i could do was ski and even that hurt at the end. Dealing with this has really made me start feeling my age.

I really look forward to get back to trail running and skateboarding.... oh and skiing!

He gunna slice an dice the other one too?

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Originally Posted by m2711c

He gunna slice an dice the other one too?

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Other than a small heal spur my other is gtg. My R got dicked up by breaking my heelbone on the runout from a skateboard bail in my 20s then overuse across the rough bone surface. I gave up the stuntwood a couple years ago look fwrd to get back after it

heal that heel amigo.

I hear you about the long,slow death of being able to do what you love. I venture to guess that i am one "up hill / push off toes" trail run away from it going. I have found some relief in biking as it really stretches out my Achilles and calf muscle- i just slide my foot further on my pedal if it is too painful at the start. Not sure about you guys, but crocs and chacos have been a life saver during the summer months. Looking at transitioning from running 4-5 days a week to 2-3 and supplement with biking

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Originally Posted by rod9301

Btw, why are you high risk to rupture your tendon?

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There’s probably a bunch of weird bone spurs and calcified gnarly shit in there by now.

5 day post op. Nerve block was clutch I never truly ended up in the pain cave by staying on pk cycle. Took one last night none at all today. No real pain as og yesterday. Getting eggey sitting in bed. Narcos on Netflix and the Redbull channel keeping me sane. Oh and a good bag of grass lol.

You'll probably lose muscle mass in your quads, hamstrings, butt.

I used a compex electro muscle stimulator after week 4. And i gained two inches on my upper legs

Pretty burly though. For quads, sit in a chair and you have to tie your ankles to the chair legs, otherwise the contractions are do strong that you can't keep your legs from flying forward.

Other companies make this, but mine is Compex.

Swear by it now.

I used to leg press 700 lbs, and now all i do is the compex. Yesterday recently and i still leg press 700, so it works.

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