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Thread: Retrocalcaneal bursitis?? Inflamation where the acchiles meets the heel bone.

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    Senior Member surf88's Avatar
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    Retrocalcaneal bursitis?? Inflamation where the acchiles meets the heel bone.

    Despite feeling fine the next day about 24 hours after I finished my 28.5 mile hike last week my left heel became really tender to the touch and stiffened up.
    If I completley stay off it (like the doctor says to do) the inflamation starts to go down, but I'm not very good at inactivity, and I cant stay home from work. I'm practicing R.I.C.E treatment the best I can, but now a week later I'm still in alot of pain when I try to walk. Anybody on here have issues with this before? Any tips? How long before you could hike again?
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    Senior Member DougPaul's Avatar
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    I've "enjoyed" heel bursitis for many years... It used to be bilateral, but the inactivity enforced by my broken leg (11 weeks non-weight bearing) allowed it to heal on the broken side. It continues on the good side.

    From what I have read, it often co-occurs with Achilles tendonitis. Stretching the Achilles tendon helps as does ibuprofen and RICE. (Generally, light activity is better than no activity.) Proper foot support (Superfeet in my case) makes a big difference for me. I also have to avoid too much (shoe) friction on the heel.

    In my case, it may hurt just after and the next day after a hike, but generally goes away by the second day with the above treatments.

    Doug

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    Senior Member erugs's Avatar
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    How is that diagnosed? I have heel pain, have had X-rays that were first read as heel spurs. The podiatrist said I do not have heel spurs, that I have plantar fasciaitis. I also have inflamation in my right hand ring finger, right elbow, now as of today left elbow and this ongoing back of the heel pain that hurts all the time. I want to claim my movingable feast of pains as being mostly related to ongoing Lyme.

    Signed, Nearly Crying in Pain
    Ellen

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    Senior Member DougPaul's Avatar
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    Quote Originally Posted by erugs View Post
    How is that diagnosed? I have heel pain, have had X-rays that were first read as heel spurs. The podiatrist said I do not have heel spurs, that I have plantar fasciaitis.
    The primary symptoms are pain at the attachment point of the Achilles tendon to the calcaneous (heel bone) and potentially visible swelling ("pump bump"). There may also be calcification which would likely show on an X-ray. IIRC, it can be hard to distinguish from (but may co-occur with) Achilles tendonitis.

    Plantar fasciitis typically presents as pain under the foot just forward of the heel-ground contact point. (Heel spurs may co-occur.) Heel bursitis typically presents as pain at or just above the back "point" of the heel.

    Plantar fasciitis is usually an overuse injury; heel bursitis is usually caused by shoe friction. Women's pumps are a frequent cause, thus the swelling is often called "pump bump".

    Most of the above info is from: Cailliet, Rene, MD, "Foot and Ankle Pain", F. A. Davis Co, Philadelphia, 1968. http://www.amazon.com/Foot-Ankle-Pai...4875802&sr=8-5

    Doug
    Last edited by DougPaul; 08-13-2012 at 11:46 AM.

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    Senior Member erugs's Avatar
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    Interesting, Doug. My heel pain is in neither of the locations mentioned, but right in between.
    Ellen

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    "Through winter-time we call on spring/And through the spring on summer call/And when abounding hedges ring/Declare that winter's best of all/And after that there's nothing good/Because the spring-time has not come... William Butler Yeats

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    Senior Member DougPaul's Avatar
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    Quote Originally Posted by DougPaul View Post
    From what I have read, it often co-occurs with Achilles tendonitis. Stretching the Achilles tendon helps as does ibuprofen and RICE. (Generally, light activity is better than no activity.) Proper foot support (Superfeet in my case) makes a big difference for me. I also have to avoid too much (shoe) friction on the heel.
    I should add that weight lowering exercises have been shown to be helpful for Achilles tendonitis, perhaps they are also helpful for heel bursitits. (One way to perform these exercises is a modified standing heel lift: lift with both feet and lower with one foot.)

    Doug

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    My mild case was treated with a boot (not the hiking type) for 4 weeks (NSAIDs for the pain) followed by no hiking for 3 more months in clogs with heel lift, then light hiking (read= slow short hikes) with pre-activity stretching. I'm still in the clogs except when I hike and it can still can be painful if I stretch too far.
    "I've been kicked by the wind, robbed by the sleet, had my head snowed in, and I'm still on my feet, and I'm still,...willin"

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    Senior Member DougPaul's Avatar
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    Quote Originally Posted by erugs View Post
    Interesting, Doug. My heel pain is in neither of the locations mentioned, but right in between.
    Medicine would be much easier if problems presented with only the classic symptoms...

    (And, of course, I'm only an interested layman posting on the internet. Reader beware...)

    You might find find the referenced book to be worthwhile--the chapter on heel pain is 9 very readable pages. (The book is part of a well-known series on pain*. I have found the books to be very helpful in understanding and dealing with some of my own problems.)

    * Pain series, all by Rene Cailliet, MD
    - Foot and Ankle Pain
    - Low Back Pain syndrome
    - Knee: Pain and Disability
    - Hand: Pain and Impairment
    - Neck and Arm Pain
    - Shoulder Pain
    (All are available as inexpensive paperbacks.)

    Doug

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    Senior Member Chip's Avatar
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    Quote Originally Posted by surf88 View Post
    Anybody on here have issues with this before? Any tips? How long before you could hike again?
    I have had some mild to severe foot, ankle and heel pain over the years, sort of free floating like Erugs. (*I am not a Doctor and what follows is not medical advice*): I have often used a little over dose of Aleve, maybe 6 pills at once, once or twice in a couple days, to knock out the severe pain. After that it becomes more manageable and tolerable. Longer term: staying active, in shape, stretching, maybe perscription orthotics, etc will help.
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    Senior Member dug's Avatar
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    Amongst almost every other foot injury known to man, I have been battling achilles tendonitis over the last 15 months. When it flares, the pain is immense. I have a boot the dr. gave to me that I've had to wear on three separate occasions since I first got it. I wear it for about a week, and then go back to stretching, and all is OK. HOWEVER...if I start to feel it, and go right to stretching, it doesn't help and in fact, with my last flare up, I think it actually brought it on. So, wait until after the swelling goes down to do the stretching.

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    Senior Member surf88's Avatar
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    My diagnosis seemed to be more based on the fact that I did a big milage day, and this had never been an issue before, and the way that it was tender to the touch in a very specific spot. After resting it for 4 days straight it was starting to feel better. Walking without a limp was still impossible at this point, but I found I could pedal my mountain bike on flat terrain with no pain. So I went out for a few miles on the local rail trail yesterday. Although the activity felt fine at the time, when I woke up this morning it felt just as inflamed as it initially did last week. I've never had and problems with tendons before and really hope this doesnt become a chronic thing.
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    I was once hiking with a sports medicine doctor who what telling me about a patient who was a compulsive runner. This runner injured his achilles tendon. The doctor told me that the injury would heal in 6 weeks with no activity. But he knew that this patient would fee good after 3 weeks and start to run again and reinjure it. And in the end the runner would be faced with a 6 month healing process. The moral of this story is that tendon injuries require enough time to fully heal or the complications could be chronic issues.
    "I've been kicked by the wind, robbed by the sleet, had my head snowed in, and I'm still on my feet, and I'm still,...willin"

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    Quote Originally Posted by Chip View Post
    I have often used a little over dose of Aleve, maybe 6 pills at once, once or twice in a couple days, to knock out the severe pain.
    My ulcer starts to hurt just reading that statement.
    "I've been kicked by the wind, robbed by the sleet, had my head snowed in, and I'm still on my feet, and I'm still,...willin"

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    Senior Member erugs's Avatar
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    Quote Originally Posted by surf88 View Post
    Walking without a limp was still impossible at this point...
    I will not limp, I will not limp, I will not limp. Then others don't remember I am in pain and when I make mention of my great distress I hear of their's, as though it is worse.

    The reason I try not to limp is that I don't want the awkward gait to put other parts of my skeleton out of alignment. Should I limp if I am in extreme pain? (And wishing I had taken 6 instead of 5 Aleve?)
    Ellen

    Volunteer Maintainer: East Pond Trail

    "Through winter-time we call on spring/And through the spring on summer call/And when abounding hedges ring/Declare that winter's best of all/And after that there's nothing good/Because the spring-time has not come... William Butler Yeats

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    Quote Originally Posted by erugs View Post
    I will not limp, I will not limp, I will not limp. Then others don't remember I am in pain and when I make mention of my great distress I hear of their's, as though it is worse.

    The reason I try not to limp is that I don't want the awkward gait to put other parts of my skeleton out of alignment. Should I limp if I am in extreme pain? (And wishing I had taken 6 instead of 5 Aleve?)
    sounds like these are questons for a real doctor,

    walking with a limp mean two different things if your talking about hobbling down the hall to the toilet or climbing a 4000 footer.
    "I've been kicked by the wind, robbed by the sleet, had my head snowed in, and I'm still on my feet, and I'm still,...willin"

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