My Achilles Heel: A Quacked Calcaneus?

Interesting things have occurred since last I spoke to you about my ankle. You might recall from my Jan. 22 post that I was diagnosed with Achilles Tendinitis. I wore a cast boot, did heat therapy and took an anti-inflammatory drug for a week in the hopes that it would clear up. If I did, in fact, have Achilles Tendinitis, I believe that it cleared up.

But there's still pain in my ankle that has lingered. More specifically, when you squeeze in particular spots on the sides of my heel it triggers hearty amounts of pain. Now, the X-ray I'd gotten didn't show anything, so my sports medicine doctor wisely decided to send me for an MRI. Magnetic resonance imaging, in case you don't know, is a very sensitive series of pictures of the body's internals. It can show many things that X-rays can't, like the condition I now think I probably have. He wanted to see what exactly is going on in there, but didn't make any assertions as to what the problem really could be.

One thing he DID do, however, is clear me to run in the 5K I'd been planning on for this Sunday. He said, "It's only a 5K. It's not like you're running a marathon. Go for it." Now, while that might seem insulting to some readers, I took no offense and realized that he meant that the relatively-short 3.1 mile race could do very little extra harm to my heel/ankle.

So I left his office with just as many questions as answers. What would the MRI show? What if the MRI showed something bad enough that I really CAN'T run the 5K? If the issue isn't Achilles Tendinitis, what could it possibly be?

After getting the MRI done last night, being given a CD of the images and surfing the interwebs for pictures of heels and MRIs, I've used my junior radiologist deduction techniques to make a prediction of what is wrong with my ankle. It's all I can do until the radiologist gives his/her report to my doc. So I can't be sure until 8 a.m. tomorrow morning when I have a followup, but a guy can still make an educated guess, can't he?

And boy, what an educated guess this is. I'd like to think I'm a smart guy. I am kind of "techie" by trade and actually work in a hospital, so I am sure of two things about reading medical imaging: 1) MRIs are REALLY cool and really detailed in what they show & 2) Medical films are REALLY hard to read. That said...

Based on my continuing symptoms and MRI, I think it is highly likely that I have a stress fracture in my calcaneus (heel) bone. After looking at the MRI images of my ankle/heel and comparing them to images readily available via a simple Google image search, I believe there are striking similarities between them. Check it out below. On the left you see an image I found on the Radsource Web site. It shows an T2-weighted MRI of a calcaneus with a stress fracture (indicated by the white arrow). On the right, I have displayed an almost exact T2-weighted image of my calcaneus with what I believe is a stress fracture (indicated by the yellow arrow).

(Click image for larger version)

There's other evidence in my set of MRI images that lead me to believe I have a stress fracture, but the similarities between the two indicated parts of the images above cannot be ignored. Heck, the dark line in my heel (on the right) even curves in a very similar way to the fracture in the left photo.

So, where does that leave me? It leaves me waiting to see my doctor tomorrow morning to find out what's REALLY going on. I also have to wonder what kind of treatment and limitations I might have in the near future. Most articles about calcaneal stress fractures indicate that a standard treatment is a lot of rest for up to 8 weeks. That may even include a cast and no weight bearing for that period.

If I do have a stress fracture and I have to wear some kind of cast or cast boot, I'd need to work with my doc to see if it'd be acceptable to do some walking in order to fulfill my job responsibilities. As someone who typically walks about 11,000 steps a day at work -- and who only has about 1 1/2 weeks of sick time accrued -- I would really need to find workarounds so I can heal but still work. I've thought about proposing using a rented scooter to motor around my workplace and then park it when I get to whatever room I need to work in. When finished at a particular location, I could scoot away to somewhere else. Minimal walking while the job still gets done. It's worth a shot.

And the 5K? Well, if I really do have a stress fracture I doubt the good doctor would still be okay with me running it. After all, it might have been running that caused the problem in the first place.

But hey, I suppose there's a possibility that I don't have a stress fracture. Maybe, even though the MRI looks ridiculously similar to other confirmed cases of stress fracture AND the fact that I have symptoms that are completely consistent with said condition, I don't actually have it. We'll see. But as I've told my wife and a few others today, "If it walks like a duck and it quacks like a duck...it's probably a stress fracture." Wait, what?

I'm planning an update to the blog tomorrow with the final news. To stay remotely on point with this blog, however, I will finish by saying that I have a feeling this is going to negatively affect my barefooting mojo...again. Hopefully, I'll be all better by the time warm weather comes around and it's prime barefooting season. I guess we'll see.

I welcome your comments below.

Detective image: http://mohsinali.name/wp-content/uploads/2009/02/detective.jpg
Scooter image: http://electricwheelchair-electricscooter.com