Achilles thingos...

[Dave Bremers]

I bwas walking on the main range today (Kosciuszko...) on really easy tracks with a fairly light pack (though not by under10kg's standards). All of a sudden the sort of bunion thing on my heel flared and I could hardly walk. Has anyone else trouble with these? I've hiked a long way and I think the lump is from blisters on blisters. Any advice/recommendations?

[bluewombat]

Look up sports physicians in the ACT phone book (there are a number of excellent ones) and see one sooner rather than later, this problem can become very chronic.

[Jellybean]

Look up sports physicians in the ACT phone book (there are a number of excellent ones) and see one sooner rather than later, this problem can become very chronic.

Excellent advice! (Please note Brem that a sports physician is very definitely not a GP - they are a doctor with additional sports medicine qualifications and definitely the person best placed to diagnose and recommend treatment for your problem. GPs do not have this specialist knowledge).

[Dave Bremers]

OK will do - I was thinking podiatrist but this may be a better option. Thanks for the advice, I'll post how it goes.

[Nuts]

Wouldnt you be better off starting with a GP ? Could be just a heel spur or something easily diagnosed (and cost less)

[Dave Bremers]

Hmmm. Thats probably a better idea. Post again nuts to get 1000 posts!

[Jellybean]

Wouldnt you be better off starting with a GP ? Could be just a heel spur or something easily diagnosed (and cost less)

In a word ... no.

For this sort of thing 9 times out of 10 seeing a gp first is a false economy. It may seem that the cost of seeing a gp first is cheaper than the sports physician consult fee but when a gp misdiagnoses and sends you down the wrong path of scans/treatment (it's happened to me and I've seen it happen to others on many, many occasions) ... you are better off seeing someone who is specialised to provide this advice first. Result: faster, more accurate diagnosis, correctly identified and ordered scans (if required) and treatment (and less wasted time, money and frustration). With the Medicare rebate the cost of seeing a sports physician is not huge. (I haven't been to a sports physician for a couple of years but last time I was out of pocket max $60. It was worth every cent). I wouldn't think about seeing a gp for a musculoskeletal injury (and my gp - who knows my sports background - would be the first person to tell me I probably know someone who is better placed to provide advice about such an injury .. and ask who it is! (I've been involved in high performance sport for over 20 years - various capacities - athlete, coach, high performance management).

Note: I have nothing against gp's - mine is awesome for gp type issues and gp's generally do a great job with general purpose medicine issues but they are not generally (i..e, very rarely) good at diagnosing and recommending treatment for musculoskeletal injuries, they don't do the training in this area that sports physicians do.

[Son of a Beach]

It's worth keeping in mind, however, that some specialists will not see you without a referral from a GP.

[Jellybean]

It's worth keeping in mind, however, that some specialists will not see you without a referral from a GP.

Sports med has only recently been formally recognised as a "speciality" (despite the extra 4 years training required to become a sports physician). Certainly prior to that it was rare to require a gp referral, I don't know the current status. Just ring the sports physician and ask! (I saw Rob Still about my knee when I was doing some work down in Canberra. He was excellent but as bluewombat mentioned, there are a number of good sports physicians in Canberra).

[Ent]

Hi Brem

Are you talking about a nodule that forms at the bottom of the Achilles tendon? If so I suffered from this when running and was told it is a problem with the sheath around the tendon not appreciating the repeated use. GP prescribe rest (yes worked but wreaked fitness campaign for Burnie Ten), physo prescribed various exercises plus stretching and shoe heel raises, did not work, and masseur used thumbs and launched me off the table swinging but this worked the best if you can endure the pain. Walking is not a problem nor riding a bike but running is bad news for mine and if not treated will bring me down lame despite my usual stubbornness in switching off to soft tissue injuries.

Regardless get it check out by a "proper" doctor and aim for one that is a runner themselves as they understand that while rest works it destroys training regimes. Nothing like having a doctor that experiences the same issues as yourself in my experience.

Cheers

[Dave Bremers]

Have booked myself in with a sports physician here in sydney for tomorrow. Will let you know the results.

[Jellybean]

Have booked myself in with a sports physician here in sydney for tomorrow. Will let you know the results.

Didn't realise you were in Sydney, I would've recommended someone (although I guess your ability to get to them would've depended on where you are in Sydney. Sydney is such a traffic-clogged rat race).'Thought you were in Canberra. Who are you seeing?

[Dave Bremers]

Well my profile says canberra so fair enough - i only moved up recently. Dr Ibrahim I believe

[Jellybean]

Hi Brem,

I've never been to him or worked with him on teams but I understand he has a special interest in tendons (most sports physicians are good across the board but tend to have a special interest in particular areas) so you should be in good hands.

Agree with one of the earlier comments, tendon injuries need to be addressed early, otherwise they can become chronic (long lasting) and hard to get rid of.
'Hope it goes well.

Cheers,

JB

[Dave Bremers]

Hey everyone,

I'm back with a diagnosis: "Pump Bump" - basically the friction caused by rubbing makes the body produce more bone in that area, which in turn creates more rubbing... etc. etc. Cortisone can be used in minor cases to reduce it slightly but mine is too big for that, on the left heel anyway. Surgery is a last resort but as it is actually underneath my achilles I don't want anyone cutting around there. There some Greek demi-god who had a weakness down there so if it can cripple him it can do me too. (haha, obviously his name was achilles, I'm not stupid).

Solution: Stay away from anything that rubs there, such as my hiking boots, and within 10months or so it will reduce back down to a better size, it will never completely disappear without surgery however. Not that it actually matters, just something to keep in mind for hiking.

It won't stop me hiking, it actually gives me an excuse to try some more of under10kg's tactics. And I've been dying to get some new trail runners...

DB

[photohiker]

It won't stop me hiking, it actually gives me an excuse to try some more of under10kg's tactics. And I've been dying to get some new trail runners...

DB

You're not the first, and you won't be the last.

The upside is that you will lose about 1kg off your feet in the process.

[Dave Bremers]

The upside is that you will lose about 1kg off your feet in the process.

Exactly.