Richard Haynes PTA/CPT - 8/21/2009

Question
I ruptured my Achilles tendon four months ago and had surgery involving the grafting of donated tendon tissue to repair the complete rupture. This was followed by six weeks in a plaster cast and crutches, and then six weeks in an aircast. I am still in the aircast, walking reasonably comfortably in the boot. However, I have developed a spot of extreme sensitivity underneath my heel that is painful to stand on both in and out of the boot. It feels as if all my weight is being borne by the heel. In your opinion, is this a matter that could be corrected by exercises to relearn proper walking or is it possible that an infection could develop this long (12 weeks) after surgery? Any rehabilitation advice would be welcome. Thank you for your time.

Answer
Hi Fran,

I do not believe it's an infection from what you are describing. I would suspect it may be something that has developed in your gait pattern as you mentioned. Its hard to answer that over the internet without seeing your gait pattern but, after that type of surgery there may be some compensatory motions involved.

The heel could be bruised underneath inside the soft tissue. Are you using a cane to walk with? If not, you may want to consider that until the heel problem clears. Always place the cane on the unaffected side. It will take some pressure off the heel.It may then help clear it up.

Try icing the heel after a full day up on your feet for 20-30 minutes to see if that relieves it.

You may have what is called a heel spur that developed, though  most of your pain will be felt in the morning when you first get up and try to stand on the heel, and the pain will decrease some as the tissue on the bottom of the foot is stretched and warmed up. There are stretching exercises that can be done for that IF that is the problem.

You may consider going back to the doctor if you have continued problems as he can put a set of eyes on the heel and see first hand how you walk etc...

Try these methods I have mentioned first.

Let  me know how you make out.

Regards
Richard Haynes PTA/CPT
Punta Gorda, Florida
http://www.richardhaynes.com