###Background:###

I work an office job 10 hours a day, excercise at the gym everyday with heavy weights. Not a runner or long distance athlete but i do get up and walk around for a few minutes every 30 minutes or so. At home im constantly active with a 2 year old so im always on my feet. What im trying to say is, physical activity should not cause the kind of injury you can read about below. I think it was the shoes.

###The shoe:###



I ordered about 10 DIFFERENT shoes online before this hikeincluding adidas, inov-8, la sportiva, and many others. I sent all of them back except the wildcats. The LaSportiva wildcats fit the best, they had a wide toebox and a moderately snug heel fit. They dried fast, were lightweight, had sufficent coushioning and a good grip on the trail.

Note the back of the shoe near the heel, it has a hard clear plastic fork shaped piece that rises up the exterior of the shoe cradeling the heel. This may have been the source of my agony. The soft mesh area above this piece is flimsy and allows that piece to dig into the achilles, it provides no resistance.




###The hike:###

75 miles on the AT, mountainous terrain Virginia, North carolina, typical AT stuff, 5 days.

###Packweight:###

27LB @ day 1, used poles.

###Bodyweight:###

150LB

###The problem:###

By day two i was having a nagging discomfort in my achilles. The morning Day three was horrible and it got worse and worse and worse. It seemed like the back of the shoe near the heel(in this shoe it has a rather high rise to it) was digging into my achilles-thats what i think anyway. I considered cutting an inch of this high rise off. When hiking, the pain was less but when i stopped the pain became concentrated and unbearable. It hurt worse in the morning and when resuming hiking after a break. I knew that hiking made it worse, but i had to keep going. By the middle of day three i needed medication. I can take pain, but this was excruciating. I managed to grit my teeth and finish the last two days. My achilles was sore for a month after that and i had to use crutches for over a week. The pain felt like a grinding inside and upon closer inspection at home, actually made a creeking noise. This was a SHARP STABBING PAIN.

Can anyone help me identify the cause, was it overuse of the achilles or the shoe digging into the achilles? I've done several long distance hikes before in inov-8's roclite 315's and 390's and never had anything like this.

Edited by isaac.mouser on 05/16/2012 12:19:30 MDT.

That sounds like a more egregious version of symptoms I had in May 2010, with the original New Balance MT100. The unpadded heel on that shoe rubbed my achilles and caused inflamation. A few days after that trip they emitted a scratchy, plasticy creaking sound when a pointed and retracted my toes.

It took 6+ months for the symptoms to go away entirely. I was able to hike that summer, but had to dial back my ambition/distance quite a bit. Patience was the only cure.

Sounds like an overuse issue to me, but I'm no doc.

I've had a few ill fitting shoes rub me raw in the achilles area over the years, usually after long runs or high mileage hiking days, but the pain associated with that never lasted for more than a day or two after activity and never advanced to the point of requiring crutches.

Check with a professional and have them check for achilles tendonitis, which is a fairly common overuse injury.

Just my two cents.

I don't know what the cause was. I do know that as we age the achilles becomes more likely to have problems. It's a common problem for middle-aged men, who don't take notice of changes in their body and try to do things the same way they did them (e.g, without stretching) when they were younger.

There's a huge amount of information on internet about achilles tendonitis. Hard for the layperson to make sense of it all given various causes and differences between people. Looks to me like this product might be useful in your situation, though: Achilles heel guard

My own achilles problems are mostly driven by excessive tightness in my calf muscles. For that I've taken to using a foot rocker ( foot rocker ) and a night splint ( night splint ) . Both of these help, but aren't complete cures. Even rest, say six months of rest, doesn't fix problem for me, since unless I take steps to keep calf somewhat loose my achilles problem recurs if I over-exercise or don't have calf loose enough.

Edited by hes on 05/16/2012 13:10:34 MDT.

i concur with that, when i pointed or retracted there was a scratchy creaky sound like an old door that needs oil or pam.

Herbert,

i am 26 and do not consider myself terribly out of shape. But to go from sitting at a desk to a 75 mile 5 day hike could have something to do with it.

Ike -- Ha, if you're only twenty-six then I think you don't need to worry about it being age-related. You haven't even reached your prime.

If you can identify a friction point that's linked to the pain I think you've got your cause, at least the primary cause. Like others have said, though, tendons are slow to repair themselves. One other thing that can is periodic icing of the area, try 15 or 20 minutes twice a day and see if it helps: http://www.mayoclinic.com/health/tendinitis/AN01695

Edited by hes on 05/16/2012 14:39:29 MDT.

Hi Ike

Herewith my guess, based on my own experiences when I was much younger. I think that:

The heel cuff was pressing against the skin over the archilles tendon. This meant the archilles tendon inside the skin was (sort of) rubbing up and down against the skin as you walked. The tendon itself is actually covered in a sheath with lubricating fluid (synovial fluid) inside the sheath to handle this friction, so normally there is no problem.

However, when you are out walking the whole day, the constant pressure and rubbing on the sheath can cause it to abrade away, eventually leading to a leak in the sheath. The synovial fluid leaks out and then you get real friction between the tendon and the sheath. That causes further abrasion and tearing. The friction may even cause squeaky sounds or feelings. At this stage there is pain and inflammation.

If you keep walking the pain saturates and may become slightly numb. When you stop and rest, the numbness wears off. When you start walking again ... oh dear.

Healing the sheath can take months. It does not have a fast rate of regen. Healing is helped by rest, not by exercise!

Some people suddenly doing a lot of typing suffer from RSI: repetitive strain injury, or carpel tunnel syndrome, at the wrist. It's the same thing. All sorts of surgical 'cures' are suggested, mostly bad. Amateurs suffer far more from it than professional typists. That is usually because the pros have conditioned their wrists (during training as a typist) to handle the extra workload.

Rest, and choose your shoes more carefully next time. Yes, different brands do have different shapes at the heel. My heels go straight up with no indent at all. I find the New Balance lasts work for me. The La Sportiva brand comes from Italy, and the Italians do (imho) seem to have narrower feet and more pointy heels.

Cheers

I started having similar problems probably due to longer times seated at work and taking up running a couple of years ago. I'm still working on the tight achilles and I also have a tight hip flexor which contributes to the problem. Here's what I am doing: I switched to an adjustable stand up desk (http://is.gd/Wj7xgr) and am rolling out my calf muscles and legs with a Trigger Point roller (http://is.gd/y6eigA). The jury is still out on if things are improving since I can't manage to consistently set aside time to stretch but I feel better than when not stretching at all.

M

I'm really glad that I stumbled across this thread because I experienced similar symptoms while hiking Buckskin Gulch (Utah) in October 2010, and I’ve always been curious as to what was wrong with my achilles. Like Ike, I am in my late 20s and am fairly active (weights, swim laps, etc.), so I was surprised to find myself in pain on day 2 of a 40-mile, 3-day hike. Having never experienced the problem before, I'm convinced that the issue must have been related to my shoe selection (Keen Newport H2s) for the hike, which meanders through the Paria River most of the time. Specifically, I think it was the mud from the river bottom that caused my tendonitis. With each step my Keens would sink into the clay/mud anywhere from a half-inch to two inches, and each time I had to dig in with my toes and leverage the achilles to get them out.

Fortunately for me the cold water of the Paria helped numb the pain and keep the swelling down, but as soon as we got back to the car my ankles exploded. It was honestly some of the worst pain I've ever experienced (maybe second to sciatica). Like some of the others who have chimed in, my achilles sounded like an old door hinge in dire need of WD-40.

While it didn't take me the 6 months that it took others to get over the pain, I was literally off my feet for two months. No gym. No laps in the pool. Nothing. I was convinced that my achilles was going to snap just walking around, so most of the time I shuffled. Sorry I can't give you more optimism, Ike, but be proud you made it as far as you did. Achilles tendonitis is no joke.

Roger identified it properly. Tendonitis due to excesstive "point pressure(s)".

In a 2 day, 200 mile Canadian Ski Marathon in teh early '80s I got tendonitis on my left wrist caused by wearing my wristwatch. Same exact symptoms as Ike.

Cure: wrist brace and rest W/ Ibuprofen to reduce the inflammation. Today I'd add Alleve for the pain. ("Climbers' Medicine" > "IBelieve" - 2 IB tabs & 1 Alleve tab) :o)

DISCLAIMER: Take at your own descretion, NOT my recommendation.

I recently purchase a pair of Wildcats and walked Sydney around for a couple of days with no issues. But a few days later I started getting a stabbing pain in my left achilles which has since gotten only worse. I have experienced something like this before, but on my right foot, and it developed a noticeable bump. This time it's my left heel and there's no bump, but the pain is similar if not worse. The thing is I've recently got prescription orthotics to deal with some plantar fasciitis on my right foot, so now I'm not sure which thing or combination of things is causing this new pain.

And I'm only 26, and never had foot problems until this year. =(