After 10 days of pain…

Patient B got in touch and came to the Sussex Foot Centre clinic for an opinion regarding pain in the back of his heel.

The pain had been present for the last 10 days and had been described as the sensation of a sudden pull and a feeling of a ‘gunshot’ going off in the leg. The patient was only able to walk wearing walking boots and even then the pain came on after only 200 yards.

When examining the patient he had a large bulge at the back of the heel where the pain was focal. Ultrasound was used as this is the best imaging modality to assess the back of the leg. MRI is widely regarded as the best imaging technique for looking at damaged soft tissue, but interestingly this isn’t the case when looking at the Achilles’ tendon.

Ultrasound can be used to look at the Achilles when it’s relaxed and when it’s stretched out. It can be used most specifically in this case, for visualisation of where the Achilles’ tendon inserts into the bone.

An example of what a normal Achilles tendon looks like can be seen below:

And this is the Achilles of the patient in question:

It’s important to see the healthy tendon has good clear straight lines, this is collagen and this is what a tendon should look like as it inserts into the heel bone.

This one, however, is what he came with. This is a chronic condition called Achilles insterional calcific tendinitis. The exact cause is unknown, however, essentially overuse and traction with inflammation on the insertion of the tendon onto the bone is the common cause. The tendon is intact on the right side albeit there will have been ‘some’ fibres that will have been pulled off.

The patient doesn’t want surgery for an Achilles debridement, and doesn’t want to wear a walker boot so I’ve manufactured orthotics for both shoes to take the strain off the Achilles’ tendon and prevent it from pulling where the Achilles inserts into the heel bone.

I have reviewed this pain already after a week and it feels significantly better. It’s a chronic condition that will be managed and we will get the patient back to exercise in 6 weeks, but only with the strain off the heel.

I will be adding updates to this case study as they happen, so check back in with us soon!

If you are suffering from foot, heel or lower limb pain, get in touch with one of our experts on 01444 453874

Jonathan Collins Specialist Podiatrist

We are trusted by our clients

Amy's been extremely helpful, informative and lovely to talk to during my foot appointment the last few visits. 100% recommend their services.
Darryl Rebbetts
Darryl Rebbetts
26/10/2022
Have had scan and chiropodist treatments and both were carried out with care and I was informed what would be done. I would highly recommend the Sussex foot centre for treatments.
Sheila Stobbs
Sheila Stobbs
15/10/2022
I was misdiagnosed by my GP after injuring myself long distance walking. Now I not only know what's wrong with me, but also how to remedy it so I can walk again. Great attention to detail. Thank you 😊
Liz Platt
Liz Platt
09/10/2022
Fantastic experience with the whole practice, there’s no where I’d trust more. Originally I went to have one issue sorted out, and have found another to be dealt with alongside. A practice where you feel listened to and taken seriously. Thanks again!
Nikki Martin
Nikki Martin
07/10/2022
Had an appointment with Jon Collins about a sore heel. Had a scan on both heels, which was followed by a detailed analysis of the results and an explanation (in layman's terms) what the issue was. Very impressed with his knowledge, how it was imparted and happy with our agreed action plan.
Jonathan Whitnall
Jonathan Whitnall
25/09/2022
Over the last 4 years or so, I have visited a number of professionals including physiotherapists, chiropractors and osteopaths. I was experiencing recurring injuries in my left knee and hip from sports and from attempting to walk mid-distances. The pain was starting to flare in my back too. I was following the physiotherapists’ advice religiously and attending appointments regularly. However, the programme of exercises tended to make the pain worse rather than better. To add to my frustration, I was also misdiagnosed with a hip condition. In the back of my mind, I always felt there was something biomechanically incorrect in the way I move but I was reassured that was not the case until…..I booked an appointment with Jon at Sussex Foot Centre for a gait assessment. Jon quickly recognised the issue with my feet and their incorrect positioning. I was prescribed custom orthotics and after a few months of perfecting these, Jon then created my semi-permanent pair of orthotics. I have been walking further than I have done and am now back on the courts playing tennis, which I love, and never thought I would be able to do again. The whole team at Sussex Foot Centre are very helpful and efficient. My treatment is ongoing so as long as Jon is a podiatrist, I am his patient :) Thank you for everything!
Katherine Morley
Katherine Morley
22/09/2022
I had nail surgery last October and after all this time I can say it was worth it. Jon didn’t rush me into it and gave me all options available, in the end I decided to go for the surgery and Jon made it so easy and everything was explained to me before, during and afterwards. Any questions I had were always answered by Jon or one of his team and put my mind at rest (I’m a bit of a worrier). Can’t thank them enough for helping with something that I had tried to ignore for years.
Gavin Robertson
Gavin Robertson
01/09/2022
I highly recommend Sussex foot centre. I booked an appointment for the shoe insoles and Jon was very helpful and professional. He provided a great solution for me and I feel much better since I wear my new insoles. The entire team is also very nice and helpful with booking the appointments around my work schedule.
Michał Piotrowski
Michał Piotrowski
22/07/2022
After the NHS screwed up my ingrown toenail operation twice this year I decided to go private and it was the best decision. I was seen really quickly and toes healed within a couple of weeks, highly recommend sussex foot centre.
Lauryn Spink
Lauryn Spink
22/07/2022