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Sports Medicine

How long to full recovery post Achilles Op.?

05/13/2010

Question:

I suffered a complete rupture of my right Achilles in Dec 08. After 8 weeks in a cast and 14 months of physio re-hab I am still suffering from an excruciating pain in the bottom of the heel. A pain that can only be described as a knife touching a bone. Should this be normal? The physio believes that my Achilles has made a good recovery, however I am concerned of this pain that has now been with me for the past 6 months.

Answer:

If you haven't done so already, please find out from your physician why you may be having these symptoms, and/or consider getting a second opinion, since a diagnosis requires findings from physical examination and possibly also from such diagnostic tests as imaging (X-rays, MRI) and/or electrodiagnostic studies (EMG/NCS). Healing should have occurred long before the 16 month period you mention; persisting pain doesn't necessarily mean "healing" hasn't occurred or been completed.

Pain in the bottom of the heel could be coming from the heel (for example, due to plantar fasciitis, subcalcaneal bursitis, a calcaneal stress (or "insufficiency") fracture, or a problem involving one of the nerves traversing the heel (such as the medial calcaneal or lateral plantar nerves) or alternatively, pain in the bottom of the heel could be referred to the heel (for example, due to an irritated/"pinched" nerve in the lower back). Alternatively, and particularly if there's a "burning" component to your pain, it could be due to what's referred to as a "complex regional pain syndrome."

Certainly feel free to discuss these possibilities with your examining physician, and hopefully this information will be helpful.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University