Severe heel pain and Achilles tendon swelling in a runner


Q: I am and avid runner and currently am NOT able to run because I have severe heel pain (calcaneus) accompanied with swelling on my Achilles tendon on the posterior side of my left leg. I have yet to get a straight answer from anyone about what exactly this is and what I should be doing to treat it. I have low arches and pronate. The swelling has gone down significantly from where it was 3 months ago and the pain only really occurs when I try and run again.


A:    The heel pain that you described might has been produced by a acute injury of the plantar fascia: plantar fasciitis, during your training; on the other hand and according to your description  of the swelling of the Achilles, you might have had a Achilles Tendonitis, which is an inflammation of the heel tendon, usually resulting from overuse associated with a change in playing surface, footwear, extreme stretching or intensity of an activity. Sometimes called the heel cord, it is the largest tendon in the human body. When the calf muscles contract, the Achilles tendon is tightened, pulling the heel. This allows you to point your foot and stand on tiptoe. Certain illnesses (such as arthritis and diabetes) and medications (such as corticosteroids and some antibiotics) can also increase the risk of rupture. Injury can happen in these situations: You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully overstretching the tendon or as in your case a forceful stretching of the calf muscles. Treatment must reflect a balance between protection and early motion: Protection is necessary to allow time for healing and to prevent re injury. Moving your foot and ankle is needed to prevent stiffness and loss of muscle tone.

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