I am still dealing with some ankle crash aftermath as well as the chronic heel pain. Repeat MRI did show some lingering bone bruising, tenosynovitis, and a grade 1 sprain to my spring ligament. Good news is the fracture and the grade 2 partial tears did heal! I briefly made it back to downhill skiing for a few weeks, but the season is over now. I was still not walking for fun or exercise during this time, but skiing was kind of OK for shorter periods. I'll take it because I thought skiing was totally off the table this winter!
I had two options to explore about a month ago.
So on to the next idea! I telehealthed with a leading expert in all things heel/nerve pain related. His name kept showing up in countless papers I ran across. He is not in my state, but he had me to visit his colleague who is in my state! This new podiatrist does ultrasound of my fascia to measure the thickness (over 4mm usually linked with plantar fasciitis/fasciopathy) and said there is definitely thickening and inflammation present in the heel area and this is likely the source of the medial heel pain. Wow, all this time I thought it was fasciopathy where there is no "itis" or inflammation present. But in fact there was and a lot of it! Was there inflammation going on for all these years of heel pain? Maybe? Anyway, we do a 6 day trial of oral steroids. He said if I get relief, this is inflammatory in nature. If I get no relief, it's likely nerve in nature, and we go on to the next tests. I get major relief, felt like a million bucks! The next step is to get a steroid injection to the area. I've heard how painful steroid injections to the fascia can me. He does not injection INTO the fascia but NEAR the fascia. This is good news because it was not nearly as painful as I was thinking, and it is giving me relief as I type. However, I have to stay off my foot as much as possible. Not full on crutches, but no extra walking, no squats, no added weight, no added repetitions. PT has updated my routine to be more non weight bearing and we're using BFR again. I'm only a week into the new steroid injection and it's still helping. However, I can still feel some spring ligament irritation going on. The new podiatrist is hoping that restoring a normal gait thanks to elimination the heel pain will help resolve the ligament sprain issue. We shall see. He is having me do a lot of stretching of the calf which seems to not agree well with the spring ligament. If the heel pain comes back soon, he suggested an endoscopic fasciotomy next. This is surgery. Hopefully my next update will have some good news!
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AuthorA 45 year old active female who tore her ACL in January 2017 (at the age of 40). Reconstructive surgery in February 2017 with bone-patellar tendon-bone autograft. Archives
November 2022
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