http-equiv='refresh'/> Global Therapies: Pain on the heel. Plantar Fasciitis or Achilles tendonitis?

Wednesday 9 November 2011

Pain on the heel. Plantar Fasciitis or Achilles tendonitis?


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As you may or may not know, I was in London for a week or so in the past month. Doing a slightly different job to that of my daily work, standing up on concrete all day every day, and cycling 10 miles to and 10 miles from my work everyday. Definitely not in my daily routine as a Soft Tissue Therapist, and a massive change in terms of the FITT principle.

It hardly comes as a surprise when I change the type of shoe I walk around in every day, the type of exercise I do every day and reduce the amount of rest - that something in my body decides that its not happy and goes into a bit of pain.

For clarity, I should say that I was going back to help out in Ski Show, I figured that standing around Earls Court for the best part of a week and a bit in minimalist trainers might hurt my feet quite a lot - so I should go back to a pair of trainers with some "squishiness" to help me out. That, added with cycling everyday for 2 weeks when I haven't been on a bike for a good few months, in biking shoes I haven't really got on with...

After a week of this, I began to feel a little bit of a twinge in the right heel - just on the lateral (out) side of the foot. Funnily enough, I only felt the pain (like a tearing sensation) when my leg was straight and the foot was dorsiflexed (toe pointing upward). When the leg was not straight and the foot was in the same position, the sensation wasn't there.

From that I can work out that its probably an issue with the gastrocnemius rather than the soleus - that's the muscle which goes from the achilles tendon to above the knee joint - as opposed to the one which originates below the knee.

I can happily say that its not plantar fasciitis simply because its not on the plantar (bottom) surface of my foot. Boom. It's not plantar fasciitis.

So, what can be done? Well, from the looks of things, its the gastroc which is causing the issues, so in terms of exercises, I'm not doing anything. Well, maybe a little bit of walking, but certainly not running, I might get on the Turbo at some point this week to see if there is an issue with being on the bike, but I am keeping well away from running - mainly because it involves an awful lot of dorsiflexion with a straight leg. I'd rather just stay off the hills for a few weeks and have it heal faster, rather than push it and then be out for months and months.

I'm also icing it on a regular basis - 84p peas from Tesco - (Tip - if you ever come to my house, don't eat the peas) and having massage and trigger point release on the gastroc on a relatively regular basis - just for 20 mins a day every 2-3 days. Although it doesn't hurt on a general basis, there are a ridiculous amount of trigger points and tender points all down the medial side of the muscle, and it certainly does it good to have them released, so as to relieve pressure on the achilles tendon and the bursae underneath. One other possibility is that its not tendonitis, but might be bursitis, in which case the treatment that I'm getting for it and the things I'm doing and not doing are helping the healing process, no matter.

However, as I have mentioned in other places, being injured is pretty boring. I don't think I'll do it again.

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