achillies heel injury

by louise
(london)

My achillies heel operation was a year and a half ago now

And I have a metal plate and screws
I am still experiencing pain and it is still swollen and fat at the back of my heel
I only find it comfortable to wear footwear with a small heel and anything flat pains me more
Is any of this normal
Also I was advised to stop taking the pill is this correct
I am a 30 year old woman and. Now anxious and worried I work full time but it is an office job and have 2 children 1 of only 22 months so my life is full on
Appreciate any advice you could give me
Thank you

RESPONSE

Hi Louise,

I am going to make the assumption that you had achilles tendon surgery because you tore you tendon. You do not mention why you had the surgery so I will make that assumption.
In any event, a couple of issues come to mind. First of all you should not being having any thing more than a twinge of pain every now and then at eighteen months post op.
That, and the fact that your heel is still swollen is not a good sign.
The first problem may be that you have too much hardware in your heel. When screw and plates are used there can be a problem with them as they can be very annoying, particularly if they are too large for the area.
Unlike other parts of the body where screws and plates may be placed, in the ankle there is not much muscle and fat to "hide" the hardware so it can be a source of irritation.
My other concern is that they may have over shortened the achilles tendon when they repaired it. That is why you have pain when you are barefoot but when you wear a slight heel the foot feels better. The heel in the shoe reduces the tension on the achilles tendon and thus it is not over stretched.
I will make the assumption that you are an otherwise healthy thirty year old. Because you are still having so much pain this far down the road, you will need to either go back to your surgeon or perhaps find another one. See a different one might not be a bad idea as he or she will be able to either confirm what I suspect or come up with a different reason for your ongoing pain.
In any event, assuming my thoughts are correct, you may have to have another procedure. The second procedure might be as simple as just removing the hardware, or it may require lengthening the tendon somewhat. Depending how the hardware is inserted, just removing it may give you enough added length, but I am only guessing here since I cannot examine you.
In either event you will probably find that any second procedure done on your ankle will not be as involved as the original surgery.

Marc Mitnick DPM
DISCLAIMER