Do I need a physio or chiropodist?

[Funk]

A while back I damaged my Achilles tendon - it's improved enormously with rest and gentle use and I'm aware an aggravated tendon injury can take weeks to heal. However I'm finding it stiffens up quite a bit and I sometimes get a 'burning' sensation at the site. There is also a small, soft round bump just below the bottom of the tendon. I'm thinking of heading to a specialist to get it looked at just in case there's more I could (or shouldn't) be doing on it but I don't know whether it's better to speak to a physio (who will be more general physiology?) or a foot specialist (would a chiropodist deal with tendon injuries or are they more bunions and verruccas etc?).

It's not worth wasting my GP's time with for a referral etc as I'll just pay for any treatment work and can shortcut things; I just don't know to whom I'm best approaching as it's not something I've had to deal with before so any advice would be appreciated!

[Mr Pointy]

I've done the same & am seeing a physiotherapist. I've been warned it's a very slow process though & it doesn't seem to heal as quickly as a muscle tear.

[Bill]

Funk said:

A while back I damaged my Achilles tendon - it's improved enormously with rest and gentle use and I'm aware an aggravated tendon injury can take weeks months to heal. However I'm finding it stiffens up quite a bit and I sometimes get a 'burning' sensation at the site. There is also a small, soft round bump just below the bottom of the tendon. I'm thinking of heading to a specialist to get it looked at just in case there's more I could (or shouldn't) be doing on it but I don't know whether it's better to speak to a physio (who will be more general physiology?) or a foot specialist (would a chiropodist deal with tendon injuries or are they more bunions and verruccas etc?).

It's not worth wasting my GP's time with for a referral etc as I'll just pay for any treatment work and can shortcut things; I just don't know to whom I'm best approaching as it's not something I've had to deal with before so any advice would be appreciated!

FTFY. Sorry. See a physio, chiropodists tend to stop at the mid-foot.

[Funk]

Thanks chaps, I'll look up a local physio. The other issue is that prolonged hobbling/compensating has resulted in some knee pain so actaully the physio route is, now I think about it, all the more sensible as we can incorporate remedial work there too.

Hope yours improves quickly Mr. P.

[Mr Pointy]

Funk said:

Thanks chaps, I'll look up a local physio. The other issue is that prolonged hobbling/compensating has resulted in some knee pain so actaully the physio route is, now I think about it, all the more sensible as we can incorporate remedial work there too.

Hope yours improves quickly Mr. P.

I have the same - pain in the opposite knee. I was advised to get some shock absorbing insoles & given some eccentric loading heel raise/lower excercises to do which have seemed to help (your diagnosis & excercises may be different of course).

https://www.amazon.co.uk/Sorbothane-Shock-Stopper-...
https://www.physio-pedia.com/Achilles_Tendinopathy...

[sawman]

a physio' or a podiatrist with musculo-skeletal interest would be your best bets - probably no need to see GP initially, unless you want referring into NHS.

[Funk]

Have booked with a well-reviewed local physio - earliest appt is a week away but some of that is down to other commitments already in my diary rather than anything else.

Cheers all.

[Stephanie Plum]

Not sure whereabouts you are in the SE, but if you're anywhere near Guildford I can't recommend a guy called Andy Cornelius enough. He's based at the clinic at Fitstuff. He has sorted out so many people I know including myself and specialises in foot and lower leg injuries.

[Funk]

Thanks Stephanie, appreciated - I'm down on the Sussex coast though so although not a huge distance it's easier to go with someone local. The numerous reviews of the clinic seem excellent so fingers crossed...

[OverHonda]

sawman said:

a physio' or a podiatrist with musculo-skeletal interest would be your best bets - probably no need to see GP initially, unless you want referring into NHS.

this...

I would suggest starting with a physiotherapist - they can look at the overall body situation, potentially diagnosing root cause of the foot problem, and if appropriate refer you to a podiatrist.

[Funk]

Mr Pointy said:

Funk said:

Thanks chaps, I'll look up a local physio. The other issue is that prolonged hobbling/compensating has resulted in some knee pain so actaully the physio route is, now I think about it, all the more sensible as we can incorporate remedial work there too.

Hope yours improves quickly Mr. P.

I have the same - pain in the opposite knee. I was advised to get some shock absorbing insoles & given some eccentric loading heel raise/lower excercises to do which have seemed to help (your diagnosis & excercises may be different of course).

https://www.amazon.co.uk/Sorbothane-Shock-Stopper-...
https://www.physio-pedia.com/Achilles_Tendinopathy...

I've been seeing the physio for about 2 months now and have made good progress. He recommended exactly the same as yours did; I tried the heel inserts but hated them, they actually caused me more issues as my foot stabliity was reduced when walking and it threw everyting out of whack for me. I could see how they might help with acute or intense pain but I was already past that to the point where it was more of an on-going nagging and very localised pain only when the tendon was poked/prodded where it attaches to the heel.

I've had very good results with the tendon-loading and heel-raising exercises though which I'm very pleased with. I've gone from not being able to do a heel raise at all on my left foot to being able to almost match my right. The whole area still feels a bit 'tight' though and it still gets a little stiff and sore if I'm sat for a while, however it's more 'discomfort' than any pain. Progress for the last two months has been very good.

The new exercise he gave me last week has resulted in the tendon becoming more irritated (it's akin to a short lunge onto the left foot and then a heel-raise from that position) and he's suggested reducing the loading a bit for another few weeks as a result. In fairness he said at the start that treatment for it will involve a little trial-and-error to see what works or how the achilles responds. My knees are no longer aching from compensating either.

As part of the process he did some general checks for alignment, range of motion, flexibility etc - all came back good and apparently I have long hamstrings compared to most people. I don't yet know how to use this superpower though.