A stabbing pain in my heel, now what?

Do you suffer from Achilles tendon pain? Do you have pain in the back of the heel? There are several disorders of the Achilles tendon and behind the heel that cause pain.

You can think of the following complaints:

  • Tendinosis (structural change) of the Achilles tendon. This is sometimes associated with inflammation of the sheath of the Achilles tendon (peritendinitis). Sometimes an egg-shaped swelling of the tendon can be seen, 3 to 6 cm above the heel.
  • Rupture (tearing, usually partial) of the Achilles tendon.
  • Haglund's exostosis (bump behind the heel).
  • Bursitis at the attachment of the Achilles to the heel bone.
  • Finally, to be complete, we mention: the inclusion of the trigonum (triangular bone) at the back of the lower ankle joint. This is also counted as Achilles-related complaints.

What Causes Achillodynia?
Achillodynia (pain in the Achilles tendon, or attachment thereof on the heel bone) is usually an overuse complaint. A rupture is often caused by a (sports) accident, but occurs with an Achilles tendon that has already been weakened by overload. The aforementioned bursitis is also caused by overloading of the attachment of the tendon on the heel (due to excessive or oblique pull of the tendon). Containment of the trigone is related to instability of the heel bone.

How does this overload now arise?
This has to do with the settlement of the foot when you walk. It is beneficial if the foot rolls nicely straight over the big toe. When walking, the heel rises from the ground while the body rests on the forefoot. With proper settlement, the joints of the tarsus and of the midfoot are then 'locked' and the foot is relatively stiff: it is now easy for the Achilles tendon to give the last push and pull the foot over the 'dead point' . However, if the foot remains too low (caused by blockages in various joints) then the Achilles must overcome just too much force with each step to pull the (slightly collapsed) foot over the toes. This eventually adds up to a noticeable overload.

In that case, the foot also wraps obliquely over the big toe (often the cause of the tilt of the big toe or callus formation on the inside of the big toe). The less good functioning of the hip joint or knee is also unfavorable for the proper settlement of the foot. Achillodynia can also involve an unstable or sloping heel bone.

Achillodynia treatment
At PodoPro podiatrists we look for the cause of the overload of the Achilles tendon. Your walking pattern and the position of your feet are analyzed. Which blockages cause the foot to collapse? What support, if any, is needed temporarily to make the foot more stable? A treatment plan will then be drawn up in consultation with you.

The podiatrist will use manual therapy if there are joint blockages. In addition to 'loosening' your ankle and / or foot, a podiatric inlay (sole) will often be advised to optimize your walking pattern, so that your complaints will reduce or disappear completely. Make an appointment with PodoPro foot specialists to discuss what we can do for you.

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