16 Weeks: Benchmark Achieved but more Heal Pain

So this week I have been able to consistently get my knee to touch the wall when doing DF. I am also gaining great progress in dual heal raises to where they are pretty easy except for that last bit to get on my very tip toes. I contribute that to going to the pool 2 times a week and doing my therapy in the water where I can burn out my calf muscles more easily without putting too much strain on my achilles. Progress, woot! I am now turning to another concern which I have noticed.

When walking I get a pain in what feels like the bone of my ankle where my achilles attaches. It is not a constant pain but comes and goes randomly with different levels of walking. Sometimes pretty painful other times just letting me know it is there. What I find odd is it occurs more when not engaging my calf muscles. If I limp around it hurts more than if I force my calf to engage. Also, this area is always warm to the touch and can get swollen. I figured that would have gone away by now. Any one else experience this?

Another is I have a lump half the size of a golf ball right above where my tendon attaches to the ankle bone. It does not hurt but right below it does where the bone is. I do not remember if it was there before or not. It probably was but was less of a concern early on and I just assumed it would go away. Anyways, compared to my other ankle which is smooth and not lumpy it concerns me. I am worried it could cause the tendon not to slide as well or something? For anyone who has gone through this, do you still have lumps at 6 months or a year out?

3 Responses to “16 Weeks: Benchmark Achieved but more Heal Pain”

  1. Seeing a PT? Still doing any follow-up with your OS? Either one might have a smart opinion about the lump, and maybe the discomfort/pain, too.

    There’s an old joke (VERY old!) that you remind me of with your “If I limp around it hurts more than if I force my calf to engage.” Something like this:
    Patient: “Doc, it jurts every time I do THIS!”
    Doctor: “So don’t do THAT!”

    The bottom of the AT attaches to the back of the heel (”calcaneus”?) bone. (Pulling up on that spot rotates the ankle joint, toes down.) Based on my own 2-ATR experience, I think that pain there is NOT generally something to be worked through or ignored in a “no pain no gain” way, but a sign that you’re overdoing. Not a statistically significant sample, but that’s where my leg hurt (a LOT) after I over-did heel raises after ATR #1, and set myself back a MONTH (back in the hinged boot!) until that pain subsided.

    Otherwise, 15-16 weeks was still very early times for lots of us, when it comes to walking perfectly, “losing” the swelling, and expecting your two legs to look identical.

    If you consider the leverage or “mechanical advantage” involved when the AT rotates your ankle into a heel raise, you can see that the top end of the raise takes WAY more calf strength (and applies WAY more tension to the AT) than the earlier parts.

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  2. Norm,

    Question about your set back. Did you go into the boot because it was that painful or could you still walk with it? Mine for the most part is bearable, kinda like a bruise.

    As for my heel pain I figured it might be from overuse. It is just soo hard to not do stuff now that I am starting to be able to. I am going to lay off my leg for a few days and see if the pain lessens. I have mentioned to my OS and PT that my heel hurts. It has been hurting since I could bear weight and they said a little bit is OK and expected, a lot is not. Pain is relative so it is kinda hard to know when I am reaching where it should not be.

  3. Details are on my blog. I hadn’t exactly left my boot yet. Hinged boot, SLOW rehab, I realized that I was walking normally in the hinged boot, and had just taken my first normal no-dip steps at home that morning. When my young PT (University sports-med clinic, tho I was ~55) saw me walk, she paraded me barefoot around the whole (large!) clinic!
    Then we went back to her table and did more work, mostly exercises. She told me to do 1-leg heel raises. I told her it was too soon, because no way could I do 8 of ‘em — my resistance-training rule of thumb. She said “Just do as many as you can,” a sentence that should NEVER leave a PT’s lips, IMHO! I did maybe 3 or 4, grunting and sweating. TWO dummies!
    I then bicycled back home in the boot, but I think I’d started not using at home. (This was ~11 years & another ATR ago!)
    The pain started a few hours later. It was way worse than the ATR pain, tho the post-op pain was pretty bad. It was obviously from overuse, so coming out of the boot seemed wrong. It was exactly a month, in the hinged boot, before I could stride normally again without that pain at the back of the heel.
    I’ve always assumed the pain was from over-stressing the attachment point, the spot that hurt. But one smart guy here suggested that it might be a referred pain, and the actual injury was at the rupture site, higher up. Who knows? I’ve had referred pains before, and they REALLY feel like they come from that other place…
    Good luck!

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