heel problem

[william107]

hi

i play semi pro soccer from which i developed a haglunds deformity (pump bump ) which i kept playing with and suffered for a year . i used to be able to do the warm up in some pain but after 20 mins or so the pain subsided until after the game or training , so stupidly i soldiered on , until i could take the pain no more .

the pain i experienced was soreness on the bump (inside area of the right heel) and shooting pain right across to the outer side .

Anyway i had surgery on may 06 to have the bump removed which i did and the actual part were they removed the pump bump is fine ,the problem i,m gettin now is at the other side of were the lump was remove about an inch on the other side of the scar . which to the touch is quite sore but bearable(about a thumb size ) the rest of the area is not sore at all to touch .

If i try to run or even jog this pain inflames around the hole heel area and makes playing soccer impossible for me .

Now my question is do any of you think if this is a nerve issue and is there any injection i could get to block or heal this pain . i also find if i do any strenuous things i.e work the next day i experience what we would describe as a calf strain just below the knee at the right side of the calf for a couple of days ,the small area beside the scar also calms downs to a dull pain again over night .

For six months i have been getting ultrasound treatment on the heel 1 mhz
for 10 mins 3 times a day followed by ice on the injury ,and calf stretches .

basically everything required for rehab .


now i,m thinking of gettin an mri scan to see if they can find the root of this problem as i need to get back to playing soccer asap . would this give me the information needed or would it be a waste of time ?


i,m no physio but i personally think it,s a nerve that has been damaged in the surgery that is the root of all of this , as i just don,t think symptom wise it is tendonitis or the like as i have at times rested the heel for 6 weeks at a time
and as soon as i try anything this small dull pain inflames straight away .
i also am using the right foot wear and heel inserts, i,m 31 years old .


Any thoughts on treatments i should try or diagnoses

i would be grateful for any help .


thank you

[alophysio]

Hi

Can you tell us more?

* What do you do for an occupation?
* Are you a pro fottball player - U/S 3 times a day for 6 months seems excessive.
* Who is taking care of you? Physio. sports doctor etc? 6 months is surely too long to be recovering with little improvement?
* You mention U/S and Stretches for the calf - what about exercises to make things move and become stronger? Progressing your activity to build up to running etc?

My initial thought is to get reviewed by a good Sports doctor and start from there. Where are you based (City and Country)

Thanks

[wutti]

hi i aggree with alophysio. let this sort out by a good sports physician.
i would suggest, the fad pad of the heel might be damaged during sugery and you returned to early to play. this needs long to be heald, because there is low blood flow in this area of fad pad.
good luck

[william107]

hi

thanks for replying

my occupation is landscaping which means i,m on my feet all day .
I was off work for 3 months post op .

i,m actually from the scotland uk ,

i was actually a full time professional until i was 21
i have been semi pro since .

training 2 nights a week and obviously playing on a sat .

the physio at the club i,m currently at is taking care of me ,and not fully qualified as yet , although i thought by now there,d be improvement .

i actually said to the surgeon who done the op about 12 weeks post op , about this area of pain and he said it was tiny nerves servered in the op ,
that would heal given time .

the healing period time seemed to be around the 6 month timescale by all accounts , i had about 1/2 an inch of bone taken away .

i was waiting for the 6 to 8 months post op before i use my private health care as they will only pay a limitied amount for specialist treatment , i,e consultants fees ,scans ,injections etc ,and a qualified physio .

and you know what the nhs is like as long as you can walk they won,t give you much help in gettin back to playing sport .

I tend to agree that the fat pad is damadged i think i done most of that damage by carrying on playing when i should have stopped before i could,nt play anymore ,stupid i know, now it,s only one thumb sized area next to the scar that is constant and at times quite a dull pain thats why i was thinking this is nerve damage , i haven,t played since the op or even 6 months before it so thats about 1 year i haven,t played for .

Most of my stretching has been the usual hands on the wall leg back ones and the one on the stairs going up and down on my toes , 6 sets of ten daily if i can .

I can kick a ball no problem ,it,s not my kicking foot anyway , as i spend 20mins a day doing that now with no problems .
i was also using a rowing machine for 20 mins a day to keep my cardio up , with no pain at all , then i started to think mebbe this was holding me back so i stopped for a while , but soon as i tried to run or even jog this pain appears straight away , it,ll be sore that night ,by the next day it settles down again , but theres no way i could play .

I will be seeking out a professional physio in jan using my private health care and will be asking my dr to refer me to a private consultant , should i be looking to get an mri scan from the consultant or any kind of injection ?

p.s i had a cortisone injection in the pump bumb area before i had surgery and if anything this made the achilles area weaker .



thank you .

[wutti]

hi there!!
to be honest, if you would find a good, well experienced sportsphysio that could be enough. its hard to say anything more about your problem, because this area is such a complex region with lots of small muscles as well as muscle tendons from lower leg area. also a lot of nerv tissue around, fascia and aponeurosis etc. also it is really important to c u weight bearing because the arch of foot and tho whole biomechanics are so important and can cause hundred of problems. so my advice would be forget about mri and injection(would only reduce problems for a short period of time) and try to find a good sportsphysio how has the time to sort things out. if that doesnt work out you can still do the mri etc.
all the best!!

[alophysio]

Hi,

Thanks for the extra info.

I would certainly get in to see a good physio who is experienced with your problem. It is too hard to guess from 1/2 way around the world what is wrong with you! Also, a non-qualified physio is simply not good enough for your injury - a simple ankle sprain maybe but not this (no offence to the physio student in question of course!)

Maybe Physiobase has some good ideas about who you can see up there???

MRI either way doesn't matter but i you want to save the money, I'd wait.

Cortisone has a catabolic effect - that is, it eats tissue (which is good for scars you don't want but not for good tissue!) which is why you may have been worse after it!

Let us know how you get on...

[william107]

Originally Posted by alophysio

Hi,

Thanks for the extra info.

I would certainly get in to see a good physio who is experienced with your problem. It is too hard to guess from 1/2 way around the world what is wrong with you! Also, a non-qualified physio is simply not good enough for your injury - a simple ankle sprain maybe but not this (no offence to the physio student in question of course!)

Maybe Physiobase has some good ideas about who you can see up there???

MRI either way doesn't matter but i you want to save the money, I'd wait.

Cortisone has a catabolic effect - that is, it eats tissue (which is good for scars you don't want but not for good tissue!) which is why you may have been worse after it!

Let us know how you get on...

yeah it,s a hard one to pin down ,as it seems to be just the running thats giving me problems .

i,ll be getting reffered to a professional physio in jan , to see if he can sort out my problem through my private healthcare by my DOC , hopefully he can sort me out .

thanks for your help .

great forum for information anyway

[alophysio]

let us know how you get on!