Seth Hosmer

We see injuries like this fairly frequently in my clinic, and most of them are from running. There are a few possibilities for what could be causing the pain that you are describing, but the two main likely things are the achilles tendon (the tendon itself, or the point where it attaches to the calcaneous/heel) or the bursa right under the tendon (or both). There are a few other possibilities, but those are the most likely given the history and symptoms you describe.

The first step is getting an accurate diagnosis, including both the tissues involved, and the likely biomechanical factors that contributed to the injury.

Treatment typically looks something like this:
1. relieve tension on the achilles tendon through myofascial release of the calf muscles. Check all muscles and joints above and below the problem (there is rarely just "one" problem, usually there are a few things that need to be fixed). If there is scar tissue or inflammation of the tissue, that is dealt with as well.
2. work with the patient on their training habits and running technique, to make sure that they are not simply overloading the tissue.
3. work on self-care routine (foam rolling, stretching, etc)
4. work on a reasonable return to running plan.

I've been seeing more injuries recently from barefoot running or running in minimal shoes. While I think running barefoot or in minimal shoes can be safe and healthy, it is a big transition with a relatively high likelihood of injury. While I think that the overall goal is admirable, the accompanying self-care and training program modification is more than some people bargain for.

I do offer a complimentary consultation for people that have specific questions about an injury and what we can do to help. Call the clinic at 503-227-2279 if you would like to take advantage of this.

Seth Hosmer, DC, CSCS
www.HPChiro.com