T Nation

Extreme pain in my heel

I started HIIT this morning, 2x400 meters. This afternoon I developed the most God-awful pain in my heel - right where the achilles tendon ties in. That’s the only place it hurts.

My calves feel fine, no other soreness in my legs, nor on the bottoms of my feet.

Any ideas as to what might be causing this pain?

Thanks

Is this the first time in a while you’ve done any HIIT?

Usually when I go for a long while and start back I end up with soreness or popping in knees, feet, or hips after my first session. I usually just lay off for a week or so before going at it again and typically don’t experience any of these pains afterward.

This happened to me about 6 months ago while I was sprinting - the next day I had the same pain as I have now.

I could understand the pain if I was real heavy footed, but I run on the balls of my feet, I try like hell to stay as light as I can, then this happens.

Could I be in danger of detaching the achilles tendon?

Google “plantar fasciitis”.

Thanks for the info tme, but the pain is on the posterior heel - right where the achilles tendon inserts.

Hmm, my first guess would’ve been a bone spur, but I’ll have to admit that I don’t know definitively what is ailing you.

Anyways, below is a link to a page with descriptions of common achilles tendon problems and how to treat them. Hopefully it will be of some help.

Sounds like it could possibly be when your heel strikes the ground that you really are hitting the heel and your shoes are not absorbing the impact forces. Might be be time to try new sneaks. my thoughts.

I don’t know how to cure what ails ya, but I do know that you should not be running on the balls of your feet. The balls should come in contact with the ground first, then your heels should hit the ground and pop right off. Are your heels coming in contact with the ground. I don’t always have valuable input in this forum, but I do know a lot about sprinting, I had a great coach in high school and I watched a lot of slow mo videos of olympic sprinters, the all breifly touch their heels to the ground. If you do not, you are putting excessive strain on your achillies.

sometimes pain in this area is secondary to a bursa that lies just underneath the achilles tendon. one thing that may help is taping (doesn’t sound like it will work, but i’ve seen it do wonders on many patients). try taping the achilles tendon medially to see if it decreases pain. if it works, great. if not, try taping laterally to see if it helps. this does not confirm a diagnosis of bursitis, but it may help you to run without pain. i would probably decrease your intensity as well to give your legs some time to adjust to the new exercise.

climbon

Thanks climbon -

I’ll try taping and see if I gat any relief.

This morning I noticed that the area in question was red and a bit swollen, so maybe it is a case of bursitis.

Or else I’m one of those old farts trying to hold on too hard to my younger days.

If it is still bothering you…take a trip to your physician, a simple x-ray can determine if it is a heel spur (plantar fascitis). With a heel spur, the pain is in the heel, but the real problem lies with the plantar fascia.

Heel spurs can be caused by many things, decreased flexibility in the gastroc (calf muscle), being overweight, increasing physical activity too soon, and lack of arch support.

If this is what it is, your doctor should suggest to you to ice it (no heat), tape it, get an arch support, and REST. Hope this helps.

I would rule out Ankle burisitis…this is usually accompanied by pain in the back of the achilles tendon. You would experience swelling most likely on the posterior of the calcaneus.

This isn’t exactly relevant but it may be of interest to someone. i personally feel plantar fasciitis is over-diagnosed. sometimes the pain appears to be coming from an abnormality in the joint between the talus and calcaneus, yet the pain is felt in the heel. heel strike during running or ambulation tend to increase the pain. most often patients will report little to no pain after taping of the calcaneus.

climbon

Thanks for all your help, guys - based on what you’ve told me, and what I was able to find through searches - it seems that my symptoms are very closely related to a condition called achilles bursitis. Now I can go to my doctor without feeling like an uneducated moron.

Rainjack
The most common injuries to the area you are describing are retrocalcaneal bursitis and Achille’s tendonitis. While the Achille’s tendon is most commonly painful 2-6cm above the insertion on the bone, you could be having pain at the insertion due to tendon insertion point (enthesopathy), periositis (infl. of the covering of the bone), etc. Since you refer to yourself as an old fart, I’m assuming that you are over forty. Tendon ruptures are more common in this group, and you should treat this injury with care and do not try to “work through the pain” if it does not respond to treatment as it could progress to a rupture (remember Dan Marino). Definitely use the rest, ice, compression, NSAID conservative treatment. Climbon’s rec. of the taping tech may help. If the problem continues I would suggest finding a doc in your area that specializes in sport’s injuries and can do myofascial treatment and ultrasound, etc. The other questions are why does this continue to happen. It could be due to just the sudden change in training, but you must also address proper warm-up, stretching, leg training protocols, running surface/shoes, any biomechanical problems such as overpronation, etc.
I hope this helps, if you have any other questions let me know. BTW what part of TX are you in.

I’m in a litlle wide spot called Silverton - it’s about 80 south of Amarillo. Btw thanks for your input - can I fix this achilles thing on my own, or do I absolutely need to seek professional help?

I really think that to properly diagnose your ailment, you should consult with your physician or a some sort of sports/exercise professional. An x-ray would rule out a lot. If it is still bothering you despite RICE, then I would definitely seek some professional help. It is very difficult to diagnose something with nothing but words :slight_smile:

Good luck!

Rainjack
Obviously having a professional evaluate and provide or prescribe treatment would be the most appropriate decision, however, there are some things you can do to help the healing process. Typically, most docs would probably treat it conservatively and advise avoiding strenuous exercise to that region for 1-2 weeks while providing physical modalities and teaching you stretching/exercises to help rehab the area. If you didn’t respond to that, then diagnostic imaging would be warranted. IMHO an MRI would give you more info than an X-ray, as soft tissue injuries are not adequately visualized on an X-ray. As far as what you can do, I would try ice massage over the area until it goes numb, do this several times a day for atleast the first 3-4 days following the injury. Make sure your foot is flexed up to lengthen the Achille’s prior to icing it. You can take Advil or Aleve for about a week to help as well. Long term use of NSAID’s can actually slow the healing process. After the acute infl. stage, start some gastroc/soleus stretching. Work on this for a few days and then gradually add some strengthening exercises. Make sure that on what ever exercise you choose, that the heel is able to drop below the toes/forefoot. Perform the eccentric portion slowly. Ballistic exercises should be added with caution. If you are able to start back with HIIT make sure to warm-up and stretch prior to the sprinting. Also, ice following any strenuous activity. There is more and the info I have provided is limited due to time constraints if you have any more question fel free to PM me. Take care