Yay - I have a broken-off Achilles Insertional bone spur

Hello!  First, many thanks to all the others who write blogs here.  I find it very helpful to read about how others deal with their achilles issues.  My case is a bit different than the typical rupture.  After dealing with achilles pains since August 2011, I’ve finally been diagnosed with a long-term insertional achilles heel spur that finally broke off and some point in the recent past.  Surgical removal has been recommended.  First, the back story of my past year dealing with this, for those who are interested.

I was a lifelong runner and never had any problems until March 2011 when I banged my foot at home and broke my right big toe.  Ouch - and not even running or sport related.  My ortho casted my foot for five weeks NWB on crutches, then two more weeks on crutches PWB, and then about two more months of learning to walk again to regain strength and mobility.

I was training for a marathon before I broke my toe, so four months post-broken toe (Aug 2011) I re-started running.  I ran 1 mile, 1 mile, 2 miles, 3, then 4 - over the course of two weeks.  On the 4 mile run I got a sharp achilles pain.  I rested it for a week and then tried another run, only to have to stop after two miles.  I’ve never had any achilles issues before, so I began researching about it.  I figured out I had Insertional Achilles Tendonitis — the pain was right on the back of my heel.  The rest of the tendon was ok and pain-free.  I saw a number of docs and PTs who had widely varying treatments — heel lifts, rest, ice, heat, “go run” –etc.  All over the board.

To summarize Aug 2011 to Jan 2012, all the treatments I tried had little to no effect.  I could walk on flat ground ok, but that was about it.  And not for super-long.  Stairs were painful (especially going downstairs), as was walking more than 30 minutes total per day.  If I walked too much then I’d have much worse pain the following morning.

I finally saw an excellent PT the end of January 2012.  He noted anterior ankle impingement and limited dorsiflexion along with the achilles pains.  The limited dorsiflexion must be an effect of the casting, as I never recalled that being a problem before.  So I was put on a regimen of ankle mobilizations and eccentric heel drops to work both the ankle impingement and the achilles heel pain.  One can affect or cause the other.

These seemed to have some effect and my pain did improve a bit.  This allowed me to walk longer distances, but that was about it.  Still no running for over a year now.  About this time, I requested an x-ray in February 2012 because I had figured out I may have a bone spur at the achilles insertion.  And voila, the x-ray showed I did.  In fact an x-ray from my toe injury in June 2011 showed the spur, so the docs figure it’d been there a long time.

Here’s an x-ray of the spur from Feb 2012: http://steve.sent.com/heel-x-ray.JPG

Fast forward to last week.  I finally had an MRI done by one of the finest foot and ankle surgeons on the east coast.  I just got his diagnosis yesterday.  He said the bone spur had been attached to the heel bone, but has now broken off.  He recommends surgery using a small incision simply to remove the bone spur.  He said “2 weeks in a splint and 4 weeks in a CAM boot” for recovery.

So!  That’s the long background.  One broken toe, then achilles pain, the discovery of limited dorsiflexion, then the heel spur that broke off in my achilles.  Are they all related?  Or is the achilles issue an unfortunate coincidence?  I’ll never know for sure.  Needless to say, having somewhat limited mobility for a year now has been a huge blow.  Though being “smart” and not overusing my aching foot may have minimized the damage.   Again, I’ll never know for sure.

I don’t know whether to have the surgery or not.  I have a friend who’s had THREE spurs removed over the years, all successfully.  He’s a 54 year old multiple Ironman finisher (and fast, too) — though he’s much tougher than I am!

I’m a hardcore researcher and have spent months learning all about achilles injuries.  Yes, I know about ESWT, I tried the ARP Wave device (didn’t like it - and it doesn’t directly address my problem) –

Has anyone else here had a problem similar to mine?  The broken-off achilles spur?  I’d be curious to know how you handled it.  I’m curious if I can manage the pain without surgery or if the spur will simply cause more damage and pain as time progresses.

For now, I’ll keep doing my eccentric heel drops and ankle mobilizations and live with the dull and sometimes sharp pains.

11 Responses to “Yay - I have a broken-off Achilles Insertional bone spur”

  1. Hello Steve,

    I feel your pain, literally. I’ve run 6 marathons and love to run. Had some achilles pain back in April and took it easy. In June, I feel onto my back heal bone. Wasn’t that painful at the time, but at about 2 am woke up to a throbbing pain with a burning tingling sensation. After 2 months of taking it easy and still feeling discomfort and tightness just from walking I got an x-ray. My orthopedic doctor indicated that bone had either been growing into my achilles and broke or a bone spur broke and became lodged in my achilles. He recommended against surgery since I can still walk just fine. However, last night when I was running/swimming in a pool I felt a popping sensation in my foot. Didn’t hurt but felt loose and a little weak. I’m now seeing a sports medicine podiatrist and surgeon next week for a 2nd opinion and hopefully an action plan beyond a couple of useless heel inserts.

    I’d appreciate any updates that anyone has. I’m hoping that this calcuim that’s now in my achilles will dissolve on its own–perhaps with different PTs. Of course that popping really has me nervous. Also, the fact that I don’t have much pain, which my doctor was really shocked over.

  2. try Tenex. Toothpick sized probe removed my bone spur with ultra sound.

  3. look into TENEX. It removed my achilles bone spur with minor incision and with ultra sound zapped it away.

  4. Hi All
    Have been dealing with a bone spur at the insertion of the achilles tendon into the heel. X-rays, PT, ultra sound. I have had three injections called Prolotherapy (dextrose) the past three months. It is expensive (at least for me) about $300 per injection. My heel feels much better & I am able to walk better. However, it is not totally gone. Will have another injections Jan. 9, 2014. A better way is to use your own blood instead of dextrose. That is more expensive but is suppose to be more effective. About $500 per injection. Both are not covered by my health insurance. Maybe your’s will cover. Check it out…very interesting. Went to a Sports Medicine Doctor.

  5. Forgot…….Castor Oil applied to the area…wrap in saran wrap and place a heating pad over it…greatly helps the tightness of the tendon (Edgar Casey loved Castor Oil) I also use it on my knees. Good for lots of areas.

  6. I had my first PRP injection about 4 years ago in my bad achilles heal (right foot) at the same time I had acl reconstruction on my left leg. PRP is platelet rich plasma, utilizing your blood to the area with very little blood flow. You are correct Gia that insurance will not cover, supposedly because the medical world is not convinced as to the effectiveness. However, I know for a fact that all the NFL and college football staff have been utilizing this method to faster healing for years. Mine seemed to provide me some relief but still had issues. I decided to have another injection just a little over a month ago because it was really bothering me again to the point where ice and aspirin were not helping. Well, to shorten story the injection definitely helped but may have given me a false sense because I ruptured just a month after.

  7. I have been experiencing this same heel pain, and have been aware of the broken heel spur for over a year. I was told that I would have to be on crutches for 6 weeks and one year for recovery!! I am 64 years old with weak hands and wrists. I cannot walk very far, or for very long. I live in constant pain and no one seems to understand how much it hurts. The doctor told me he would have to split my Achilles tendon to remove the spur, which I don’t understand. I just know I am ready to get something done. Can the spur damage the Achilles tendon?

  8. Debbie- Yes if the spur continues to move around It can rub your tendon eventually possibly shredding it. Your amount of activity is a factor on how quick this can happen.. If you are not active it may never happen, but 64 is still young.

    It sounds like the broken spur is under the tendon. Since the tendon is attached to a large part of the back of your ankle/foot what your doctor is suggesting sounds normal.

    Splitting the tendon… If he means that literally it should be a vertical slice just opening a section of tendon and removing the spur. That recovery should be less time than if he means a horizontal split, where he cuts off the tendon from the bone to reach it.

    If crutches don’t work for you, you can always request a scooter or wheelchair. Insurance usually denies one unless your doctor specifically stated and send the documentation for why you can’t use crutches.

    If your other overall health is good a knee scooter may be an option.

    The best thing to do is learn as much as you can about your specific problem so you can be prepared with the questions you need answered.

    Recovery is a very individual process for all of us here. Some recover fast, others a much longer time. It sounds like your doctor gave you the worse case scenario.

    Hope this helps.

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  11. I had a broken heel spur. Dr. decided surgery was needed. I was told the bone would shred the achilles if I didnt have the surgery. Surgery was Dec 2018. I had to have the achilles removed and reattached. They also lengthened it. I only used crutches to get to the car after the surgery. I used a knee scooter the rest of the time.

    I am walking in the house without anything and using a boot when outside the house. I am a very active realtor and trying to keep myself active but limited until I heal. I am only doing limited stairs.

    While it is not what I wanted to do, it is manageable.