As you’ve found out (the hard way), these aren’t easy problems to treat. They take a different bend in their treatment as compared to achilles tendinosis problems due to the nature of the Achilles enthesis, which (per recent research) is much more complex and layered in structure than was previously understood. Nike Air Max 1 Mujer Certainly, you have to handle these problems gently – it’s not as vigorous an approach over Nike Air Max 270 Womens the long run as is typical with Achilles tendinosis (using an Alfredson protocol of eccentric emphasis heel raises), although I’ve found that you have to pursue that route eventually, once you establish a baseline of how much activity it takes to provoke the heel pain.
You mentioned your size – how tall are you and how much do you weigh? You also mentioned your ankle/achilles inflexibility – the degree of motion you noted (7 degrees) is marginal, even for shod running, much less for barefoot. Lots to look at there alone, including whether your lack of mobility is truly gastrocnemius, soleus, or just lack of talocrural mobility – those are things that your PT probably has figured out (both by measurement and by looking at your functional Nike Air Max 2017 Mujer squat ability), but you need to aim for 30 degrees of dorsiflexion , particularly if you’re Nike Air Max 90 Homme trying to train using a minimalist approach, along with 1st toe dorsiflexion flexibility. Deficits in these will show up in a video exam of your running form.Other things to consider – I often find that I have to do “surgery” on heel counters in the training shoes in those runners I treat – some shoes are worse than this than others (such as Saucony’s Fastwitch 4) – pulling down the upper off of the heelcounter and trimming down the back of it – some shoes require just plain cutting off the heeltab, as any pressure that presses on the achilles above the insertion will cause more problems. Some will recommend against using deep friction techniques on the enthesis, but I’ve found success with Graston techniques for lessening the local symptoms. Careful kinesiotaping helps with the symptoms as well. These are the band-aid things, but Nike Air Vapormax Femme addressing the mechanical /soft tissue deficits from foot up, making sure to deal with any restrictions in talocrural and subtalar mobility and any form issues and stance control both balance and calf endurance) issues become more important to resolve this. Your return to footwear to control the pain for now is smart – whether this will really cause the spur to resolve (i.e. Wolff’s law) is probably more conjecture than anything at this point.good to talk to you! Really, these can go either way (or even both) in terms of impingement. The thinking of the mechanism/purpose for the retrocalcaneal fat pad is that it acts akin to the patella as a soft fulcrum to improve the leverage of the achilles for plantarflexion. Any bony development, though,Nike Air Force 1 Womens tends to produce kinking against the tendon and instead of a smooth distribution of pressure over the enthesis, point loading occurs that increases the tendon stress.None of these problems are purely sagittal plane – you have to look at pronation/supination. Most of the time (as Allan noted himself), the original symptoms often occur on the medial side of the tendon – poorly mediated pronation causing the stress on the side of the tendon (the convexity) most under stress during stance. I often find that runners with these problems have a forefoot varus alignment, even if their rearfoot alignment is relatively normal during stance. Barefoot video analysis shows this well and I find that more reliable than trying to accurately bisect/marker the rearfoot and lower leg (though I still do so as best I can).My own 2-cents opinion, for what it’s worth- Surgery isn’t necessarily a bad option with these, as long as you resolve Nike Air Max TN Womensthe mechanical factors that led to the original spurring. Orthotic intervention can help as well if there’s either rearfoot and/or forefoot motion that appears to be driving this, although that’s not necessarily what a minimalist runner wants to hear. I’ve found that for runners wanting to go the minimalist route (short of barefoot) that you can sculpt a “cobra pad” for shoes such as the NB Minimus and have that work well to lessen the mechanical stress of pronation without mucking up either the shoe or minimalist training