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The response to the question below was authored by Marc Mitnick DPM
achiles tendon pain
The tendon that connects my foot to my ankle feels like it is full of painful air bubbles every time I move it and it looks like it is bruised, however, when I press on it, it is only mildly tender. I recently went for a long walk and my other foot is fine. My right foot feels like the tendon is being pulled almost to the point where it might come apart, filled with tiny uncomfortable painful air bubbles, then smooshed back together and the bubbles pop causing me much pain (the pulling apart sensation also hurts alot). There is discoloration like my shoe was rubbing on it but it doesn't feel like that is the case. There is a small lump that I can feel but not see on the outer side of my tendon just above the discoloration(discoloration about 1 inch long and lump about the size of a lima bean). The discoloration looks like a bruise maybe but is not tender to the touch. It only hurts when I move my foot around or walk on it. It hurt from the base of the tendon by my heel going up about 5 inches shortly after I got done walking all those miles, like I had a sore muscle and I didn't not feel the bubbles and pulling apart sensation until a day later. Now it does not feel like my muscle is cramped anymore and the range of pain has gone down to about 2 or 3 inches just above the heel. But it hurts a lot more today the it did yesterday. I took my walk almost 2 days ago. I think it might be relevant to add that I have fallen arches on both feet and I put arch supports in my shoes because they are kinda cheap and don't have them built in. I took the support out of my right shoe because
RESPONSE
Hi,
I wish I knew more about you, such as your age and your overall fitness including your weight. But in general terms, what I gather from your narrative is that you are putting a lot of strain on your Achilles tendon. I am not sure I would describe them as bubbles, but what most people experience is either a swelling within the tendon itself, that may be compressible, and thus the bubble sensation, or, an inflamed bursal sac on the outside of the tendon, just under the skin. This generally occurs from shoe irritation.
Either of these conditions will cause pain.
Without the luxury of actually examining you, I will assume you have a tight Achilles tendon. I make this assumption because of the fact that you state you are flat-footed. When people have a tight or short Achilles tendon, one of the ways they compensate for this is by pronating their foot (which flattens out the foot). By doing so, you are actually alleviating the tension on the Achilles tendon.
The problem with wearing an arch support is that you eliminate the pronation, but, that then increases the tension on the Achilles tendon. More tension results in more pain, particularly in walking long distances. This will be exacerbated by walking up hill which intuitively puts more strain on the tendon.
This is basically known as a biomechanical problem. It is the result of the structure of your foot and the way you walk.
The smart thing to do would be to see a foot specialist and have your foot and gait analyzed. With that knowledge in hand, the doctor should be able to offer a course of therapy to alleviate your pain.
Marc Mitnick DPM
DISCLAIMER
ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
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