[bigdrew]

Hi all, I've recently had pretty serious pain when wearing all climbing, and some normal shoes. After reading around I'm fairly sure it's down to Haglung's deformity / inflammation of the bursa rather than tendinitis. It does look swollen and at its worse there was quite a noticeable creaking which could be felt and heard.

I've had lumps at the back of both my heels for as long as I can remember which have never caused me trouble until about 3 or 4 weeks ago and then only on the left foot. The pain is brought on through pressure more than movement (I can hop around/do one legged calf raises no problem). Squeezing the tendon causes more pain than just pressing it.

Currently I have just been icing it and avoiding wearing shoes which bring on the pain.

Anyone else had similar problems? Anything else I can be doing to help it heal...

[sidewinder]

Hi bigdrew,
I have been having similar problems fo on and offr ages in both heels.  For me the problem seems to be caused by the lumpy bit (haglund's deformity) rubbing on the backs of shoes, this inflames the tendon thus leading to a vicious cycle.  Often I can recall the exact incident that set it off, ie ice skating in some poorly fitting hire shoes, cue 4 months of heel pain!  As far as I am aware, without major surgery which imo sounds like a bad plan the best course of action seems to be to work out how not to make it angry, here are my tips!

• Find shoes that don't rub, especially your climbing shoes, strangely I get on well with the 5.10 heels as these seem to fit around the deformity snugly preventing any rubbing, often I can still climb pain free even when it hurts to wear any other shoes!
• Wear backless shoes as much as possible, I have a ~£2 pair of Ikea fake crocs for the office and a pair of old tennies with the heel hacksawed off, to turn them into loafers, especially useful if the tendon has flared up.  I have also found my walking boots are actually pretty good as the high top means there is no edge rubbing on the trouble area.  If you find any shoes with a nice soft heel counter let me know as I am always on the look out!
• Stabilise your heel, I have found the green superfeet pseudo orthotic insoles useful as they seem to stop my heel moving around as much in shoes, therefore less rubbing.  Heel lock lacing (google it) also helps lock my heel in on some of my shoes.
• Reduce the friction, the tendon area seems to take more damage from the shoes when the friction is higher, moisturising the tendon area seems to help, especially if dry.  Some people seem to have had good results by using duct tape or similar, either on the back of the shoe or on the heel direct (eek!).  I have bought some of the foam they use to make insoles (sorbothane green, a big sheet cost ~£20, depending where you live I could probably sell you some) and am gradually sticking it to the backs of my shoes as it cushions the heel, holds the heel a bit more snugly (less movement) and has a nice shiny low friction surface.
• Stretch your legs, part of my problem comes from short hamstrings and achilles, if your tendons are short/tight, as you step down with your heel, your tendons pull your heel upwards, causing rubbing.  Llengthening your tendons through regular stretching will help stop this.  I was also told by a physio to do some side leg raises to strengthen my bum, again to help stabilise leg and heel while walking/running but I am pretty bad at bothering to do these

In terms of getting it better when it has flared up, I have found icing, gentle stretching and some massage on the area have helped me, but it does sometimes take quite a while to settle down, I also try and keep up some occasional massage on it even when it isn't flared up in the hope this might help gradually reduce the size of the lump/heel spurs.

With my combined tactics I think I am just about getting on top of managing it/stopping flare ups. which is good because the other way, chronic tendonitis, surgery and lots of time not climbing doesn't sound fun!

Good luck, am interested to hear if anyone else has input on this.

[bigdrew]

Hey, Thanks for the reply.

I have usually being climbing in 5:10's but I think it has been a change (for one day) to the scarpa boosters which has set it off

I have just been to the doctors and it turns out that it is Tenosynovitis, which is inflammation of the tendon sheath rather than the actual tendon. He said that the pain is much to high up to have been caused by the 'pump bump' as you would expect this to be where the tendon connects to the bone (Mine is about a inch higher). So I am hoping that this is a one off injury rather than something that should keep occurring!

Another weeks rest and icing for me along with the a 10 day course of NSAID's.

[The Sausage]

The only thing I'd add, is that if you have creaking of the tendon, and it's painful to squeeze, it's almost certainly some sort of tendinopathy (i.e. not the bursa).

[Falling Down]

• Stretch your legs, part of my problem comes from short hamstrings and achilles,
  

I agree with this one.  I had painful achilles for several years and did the usual local treatment.  Then I started stretching my Hamstrings and hey presto, the achilles pain subsided.

The ongoing thread on Front Squats has some helpful advice on Squats which are great for stretching the hams and general leg conditioning.

[bigdrew]

Cheers all. It seems to be responding well to the prescribed NSAID's. Hopfully it wont come back as soon as the 10 cay course finishes! I have very poor hamstring flexibility (Years of cycling and not stretching) so I will have a read of that thread and hopefully start to improve it!

Out of intrest does the pain from Haglung's deformity type injury occur on the lump its self?

[sidewinder]

yes, mainly, the lump is the insertion point of the tendon (I think) and as it in my case gets aggravated by friction and the friction occurs on the lump that is where most of the pain is, though once inflamed the tendon in general is sore.