I feel your pain! Heel pain is a common presentation in the Sports Medicine Centre and certainly we have seen a number of challenging heel/Achilles cases. As Dr Sean mentions there are a number of causes for heel pain that need identification with a good history, examination and baseline investigation. This might include a plain X-ray and an ultrasound examination.
Assuming that you have an Achilles problem, in yourger patients it tends to be mid-portion and in older patients, at the insertion to the heel bone. From the Sports Medicine/MSK perspective, treatment options include:
1. Rehabilition - this includes concentric exercises for the Achilles, stretching of the calf and hamstrings
2. Shockwave therapy on the Achilles
3. Guided injections, such as high volume tendon stripping, prolotherapy and prp injections. Often before the latter two further imaging maybe required.
4. Acupuncture
5. Gait re-training and a podiatry assessment
These are all things that are routinely offered in most sports medicine centres. Having had a number of patients who have undergone prolotherapy for really hard to treat Achilles tendinopathy and retrocalcaneal bursas, these are just some of the treatment options we used.
Hope this helps.
Bw
Dr Dinesh
