SEE UPDATES BELOW THIS POST
For me, 2011 has been a journey of healing. As I’ve mentioned in previous posts this year, I’ve been suffering from Haglund’s deformity – a chronic form of calcaneal bursitis (inflammation of the bursa sac that cushions the back of the heel) that results in hypertrophy of the heel bone. I’ve also been dealing with Achilles tendonitis which is commonly associated with this condition.
What was strange in my case is that, although this is a chronic condition, mine seemed to come on suddenly despite the fact that I didn’t change my footwear or my activities. In fact I run far less than I used to so it’s ironic that this problem cropped up at this time in my life. After suffering for many months while trying all of the standard allopathic medical treatments for Haglunds with no improvement, I decided to have surgery. I even scheduled the procedure, which involves shaving the heel bone, the permanent removal of the bursa sac and the temporary detachment and re-attachment of the Achilles tendon. The post-surgical recovery process is long and arduous and there’s no guarantee of a successful outcome or that the problem won’t return.
As the date of my surgery loomed I began to have second thoughts - particularly the prospect of a 6-month layoff from physical activity. Instead I decided to try the laser therapy and LED light therapy treatments offered at my chiropractor’s office, figuring I could always have the surgery later if they weren’t successful. Much to my delight I experienced improvement and was encouraged by my gradual progress – namely my ability to do more with less pain. During the summer I added bi-weekly acupuncture treatments and noticed a further reduction in my symptoms though the bursa and heel bone never shrunk in size. I began competing in 10ks and I even ran (and was the second female finisher) in a half-marathon. I also added a lot of cycling to my workout regime which helped strengthen my foot without pounding the pavement. As usual, deep water exercise was a staple and savior in my life and also helped strengthen my foot and keep me in shape without adversely affecting my heel or Achilles. As long as I didn’t run too much or too many days in a row I was able to continue. I was even able to return to running hilly courses and even competed in hilly races.
But by late Fall I became discouraged as my pain began to return and my progress seemed to plateau. Still adament about avoiding surgery, I began receiving homeopathic injections of Traumeel directly into the bursa. (This procedure is commonly performed in Europe though not in the US). I have had 5 rounds of Traumeel injections and plan to have one more next week. They are extremely painful and cause the bursa and overall pain and stiffness in my foot to increase for about 48 hours. The jury is still out as to whether they are effective, but I do feel that my foot is slowly changing for the better. I’ve also been taking Traumeel homeopathic tablets (instead of non-steriodal anti-inflammatories which with chronic use can delay healing) and have continued using Traumeel ointment on my heel – particularly the 2 days following the injections.
I also changed to a softer and smaller heel lift – after wearing a hard rubber one for years in my right shoe because of a leg difference resulting from scoliosis. Perhaps most importantly, I’ve been working on altering my running gait, attempting to adopt more of a barefoot style of running (but with shoes on!) instead of that of a heel striker (as I’ve been all my life). Old habits do die hard as this has proved extremely challenging for me! I’ve also discovered the joy of tandem bicycling – it’s great exercise and also doubles as couples therapy :). More on that in a future post.
I’m still hoping to avoid the knife, though I realize that there’s no other way of returning the heel bone to its original shape so I may resort to that at some point. In the meantime, other than running shoes and cycling shoes I mostly wear clogs, mules, backless sandals and flip flops to reduce the pressure on the back of the heel.
I’ve learned a lot this year in this journey of healing….most of all not to give up hope. The body has an amazing capacity to heal itself if given the right tools.
Be Well and Happy New Year,
UPDATE I: Well I went back to the Dr. today expecting to have my final Traumeel injection, however because my results have been rather underwhelming he decided to take the next step and try prolotherapy on my heel bursitis and Achilles tendonits. Prolotherapy involves the injection of a dextrose (sugar) solution (also includes Vitamin B-12 and Vitamin A) into the ligament or tendon where it attaches to the bone or any painful area. This results in a localized inflammation in these weak areas which supposedly increases the blood supply and flow of nutrients and stimulates the tissue to repair itself. If I thought Traumeel injections were painful, this was easily twice as bad probably due to the larger needle and the deeper penetration into the bone and surrounding tendons and ligaments. I had trouble walking within 90 minutes of the procedure when the pro-caine (anesthetic) wore off. Tonight I’m limping around and strangely enough it feels as though I sprained my ankle. I was told the pain and swelling would increase for approximately three days, but this is worse than I expected.
Here is a link to a video (see #11 on the sidebar of videos) of a patient receiving the injections in his foot (my injections were in the back of my heel and Achilles tendon). Don’t be fooled by the Dr.’s assertion that the injections are easily received by the patient. That was not my experience and I have a high pain threshold!
UPDATE II: I never returned to have additional prolotherapy or traumeel injections. It took me 5 weeks to return to my previous activity level prior to the injections and I experienced no improvement in my symptoms. Bottom line: this approach didn’t work for me. Currently I’m continuing my home remedies and varying my activities (alternating running, cycling, exercising on the elliptical trainer, swimming and water exercise) and being very mindful of my choice of shoes – backless whenever possible.
UPDATE III: Well it’s mid-May, 2012 and I’m happy to report that I’ve had a relatively active, pain-reduced three weeks. On the advice of my old chiropractor (whom I saw during a recent visit to Tucson) I’ve been taking a homeopathic medicine called “Osteoheel“. I do think it is helping to reduce my pain and possibly even size of the bump on the back of my heel. It’s definitely decreased the burning sensation in my heel and achilles tendon. About a week ago I started using a homeopathic ointment called “Topricin Foot Therapy Cream“. I believe it’s also working to temporarily reduce my pain and stiffness. I’ve used Traumeel religiously for years, but I’ve not found it to be effective on this foot condition – perhaps Topricin will fit that bill. I’ve also changed to a running shoe that has a smaller difference in height between the back heel and front part of the sole (only a 4mm difference as opposed to the typical 8mm difference). It also has a more flexible sole. It took some getting used to, but I’m having less pain both during and after running. I’ve even been able to run back-to-back days and a couple of days I go I did a 9-miler. I’m still doing a lot of tandem cycling and spinning where I have little or no pain and I’m in the pool almost every day – whether for work or a workout. I continue using my golf ball on the bottom of my foot to keep the plantar fascia tissue pliable. I just keep it under my dining room table where I can use it while I’m eating or working at the computer.
I’m not sure if this is just a positive phase I’m experiencing or whether my condition is actually improving. Only time will tell… stay tuned….
UPDATE IV (October, 2012): After a frustrating summer of plantar faciitis in my good foot, I’ve experienced a really good 6 weeks. Other than a bit of stiffness in the morning and occasionally some minor Haglund’s pain, both feet have been feeling really good. Even after running almost every day in France on vacation and walking miles all over Paris, my feet felt pretty darn good. I’ve continued taking the Osteoheel but only when I need it rather than taking it preventatively. The only thing I’ve done differently is completely eliminate artificial sweeteners. A year ago I stopped chewing sugarless gum, the only source of artificial sweetener I was consuming, suspecting at that time that it might be contributing to my Haglund’s pain and leg and foot cramping. My condition did improve when I switched to what I thought was sugar-based gum when I chewed it occasionally. Eight weeks ago I happened to read the label more carefully on my Wrigley’s doublemint gum packet only to discover that it now includes artificial sweeteners (aspartame mostly) in addition to sugar – albeit a smaller amount than in “sugar-free gum”. I immediately stopped chewing it and within a week my foot pain decreased dramatically. Coincidence? Possibly…but for now, I’m avoiding all artificial sweeteners and reading labels carefully. I suspect I’m sensitive to any amount of them – no matter how small. On a related note, I noticed in France that almost all chewing gum and mints for sale were artificially-sweetened – similar to the US. I doubt that was the case even 5 years ago, but it appears to be a growing trend both here and abroad. Artificial sweeteners are being linked to so many health problems that it surprises me that the market for their products is still booming, especially in Europe where, for example, homeopathy is an accepted, even mainstream practice and genetically modified foods are banned.
UPDATE V (December 31, 2012) Over the past few months I’ve gradually been able to increase my running mileage. I was thrilled to be able to do a few 90 minute runs with no negative consequences other than some post-run stiffness soreness in my soleus and Achilles – all of which went away quickly. But TODAY I ACTUALLY RAN 2 HOURS AND 5 MINUTES!!! I haven’t come close to that in 3 years. I am a bit sore tonight, but thrilled nevertheless. I feel really good about starting 2013 feeling more like my old self physically. The only other thing of note that has happened was a 2-week period a few weeks ago where I experienced sudden, sharp knife like pains in my right foot – both the medial and lateral parts of my foot – especially at the heel and Achilles. My ankle would also suddenly lock up on me. Strangely enough the pains would decrease or even subside after urination. I’ve since discovered that this is probably tiny fragments of the hypertrophied bone breaking off. Apparently this is common in the case of bone spurs. These “loose bodies” can find their way to your joint or soft tissue. Fortunately it went away, but it really helped just knowing what was causing it – especially as it was quite painful. Interestingly, my fiance started measuring the “circumference” of my Haglund’s heel with a tape measure a couple of months ago. It had been 26.5 cm before this painful episode. On Christmas Day he measured it again. It had been about a month since the last time he measured it and this time it was 26.0 cm!!! Could it be my hypertrophied heel bone is shrinking? I don’t know, but it is definitely less sensitive and the bursa is no longer irritated or inflamed.
UPDATE VI (January 2, 2013) I thought I’d better update again rather than waiting to share some additional information as well as the good news that followed the 2-hour and 5 minute run the other day. I really feared that I might be hobbling around the next day after sharing the news on my blog. Amazingly not only was I OK the next day, I felt good enough to run an hour. Even more amazing is the fact that I ran the next day (at a brisk pace – thanks to my fiance and the next day. I’m taking tomorrow off regardless of how I feel but I’m thrilled to have covered 40 miles in 4 days – especially since one of those days included that 2 hour run. Something else I wanted to share that I’ve done differently this past month was lacing my shoes differently from each other. My right foot is my Haglund’s foot – and the right shoe is the one I wear the heel lift in because of my leg length difference. My left foot has a tendency to turn out when I run so I’ve recently been lacing it at the top shoelace hole to keep that foot under greater motion control while lacing my right shoe at 2 holes lower so it is less restricted. I think this has helped – if not my Haglund’s than at least my gait. I’m a neutral runner so I don’t need motion control shoes in general, but this helps with the discrepancy between my right and left feet.
All for now…..
Tags: artificial sweeteners and foot pain, Haglund's deformity, LED light therapy and heel pain, Orthoheel for Haglunds deformity and heel spurs, prolotherapy for heel and Achilles pain, Traumeel injections for calcaneal bursitis