Hi there When you say that
Hi there
When you say that it is on the outside of the foot but on the outside of the achilles tendon I am assuming it is not on the achilles tendon as it is on the outside of the achilles tendon.
As Dr. Andrew Kline stated you said it was on the outside of Achilles tendons so he assume that was on the Achilles tendon on the outside. What you might want to do is take your iPhone or your cell phone and take a photograph of that and send it to the doctor so that we can actually see exactly where it's at.
If it is not on the achilles tendon but to the side of the tendon, above the heel and under the lateral maleolis (photo link) then it could be a joint called the subtalar joint. In my model of the human body as a human spring I list 7 floors of joints where the body absorbs impacts. This is an oversimplification but it could help you to better understand the body better as a giant spring mechanism that absorbs impact forces in these floors
1. Arch of the foot
2. Subtalar Joint
3. Ankle Mortise
4. Knee
5. Hip
6. Spine
7. Spine-Skull
In this link the big arrow is pointing to the back of the subtalar joint. As you can see it is very close to the achilles tendon.
http://www.ajronline.org/content/181/6/1565/F3.expansion
When you are talking about a team full area which is five or 6 inches long and encompassing the back of the heel and around Achilles tendon by pressing on the Achilles tendon if it elicits pain then this drain is on the Achilles tendon. If you're describing a pinpoint area of pain to the side of the Achilles tendon that's more of a smaller area around that area that is most likely the subtalar joint.
Now, if it is in fact the lateral subtalar joint, but I have found is that a lot of times patients who have pain in this area are over extending their stride causing the impact of the on the outer edge of the heel with a slight toe out (pointed out like a duck) Take a look at this link and the position of the left foot on landing.
http://www.montrealgazette.com/Fitness+Taking+changes+stride/5507847/story.html
When you are so far out ahead the leg tends to rotate out (external rotation) more causing the foot to land on the heel more and on the outside. This can irritate the subtalar joint more. Why? The rolling of the foot happens more in the subtalar joint the further the mass of your body lands from the perpendicular.
What you might want to do is take a flip camera, have her start 100 feet from you. Have her run towards you barefoot and holding your flip video camera ($130.00) super still video her legs. Then have her start behind you about 20 feet and run by you as you videotape her running away from you for the view of the back of the heel.
The next video you do will take less than 30 seconds. Have her stand 15 feel from the camera and walk with a normal pace towards the camera. When she gets 2 feet from the camera have her turn around and walk back. When she gets to the starting point again, have her turn around and walk back again 2x as fast and turn around walking back to the starting point again. By evaluating 3 speed slow and fast you see how the boot absorbs impacts at three different forces. Sometimes the foot handles the impact well at the slow and faster walking speed but when the forces triple or quadruple the suspension system landing muscles arent able to handle the faster speeds (tibialis posterior, anterior and peroneals)
Then upload the video into your Iphoto to view. Slowly advance the video frame by frame watching the way the foot on the painful side impacts the ground. What you will see may amaze you and tell you exactly why the foot hurts. If it does not, send me the video to me via www.yousendit.com and I will evaluate it myself.
The easiest way to reduce inflammation and free up a joint that is jammed is to apply direct constant pressure to the painful area holding pressure steady until you feel it slowly go away. You usully feel a drop from the initial plateau of pain in 1 minute with the pain totally subsiding after 3 minutes unless you have had this for years then it may take longer.
Before I run I do 20 - 30 minutes of deep tissue to my entire foot on the arch primarily in the area the medial border of the first toe, underneath the first toe, between the first and second toe underneath, and underneath the second toe. I've also do pressure points between the first and second toe to wedge my thumb between them to spread the first toll way from the second toe. then I do deep tissue work on the entire subtalar joint both on the inside and the outside, the area that you described above that is in pain. Then I do deep tissue around the entire ankle mortars which is the junction between the ankle and shin.
Then I grab the big toe and the toes 3-5 and separate these toes to widen the base of support for the landing. I scisor the toes one way then the other. I stretch the foot as a 3-dimensional object that acts like a spring load mechanism which works best if it is maximally released. The more motion between the joints the more force you can load into the mechanism the faster the speed and distance run without overloading the mechanism with too much force.
Then I go for my run. if I come down with slight pain anywhere I stop there stick my thumb into it and work out the spasm or pain then run again. I have noticed that when I do that my run is much smoother and faster instantly, too so try that.
Feel free to send me the video of your walk and run to my email below and with permission to load it onto my youtube channel and I will evaluate it for you on tape and repost it on this post later.
Dr James Stoxen DC
www.barefootrunningdoctor.com
[email protected]
