Hi,

Background: At the age of 8, I was diagnosed with Epilepsy, I also walked on my toes, due to short Achilles Tendons in both ankles. I was given 'stretching' exercises to complete twice a day, which my parents forced me to do religiously. Ever since I can remember (age 8) I have had SEVERE pain intermittently with both calves the only way I could get relief from this as a child was to toe walk and get my very overweight brother to essentially stand and jump on the back of my calves... No matter how much I complained of the pain I was in I was always told the same thing by both my parents and paediatric specialist 'Do your exercises and the pain will go away'... I could walk flat foot if observed or prompted, if my parents caught me walking on my toes, they would tell me to ‘walk flat foot’. I never wore a foot brace as I was not severe enough. As the years went by the stretches continued until I was 13 and essentially gave up. Jumping forward a couple of years and it wasn't until I was 15 and I shattered the medial cortex of the medial condyle in my left knee (obtained by a 50m running tryout), that I was told I have a mild spastic deformity of the legs ?CP (my ankles fold inwards when elevated and resting). After the Tx of the multiple #s, I was in extensive pain, I saw an orthopedic Doctor who diagnosed me with Osgood Schlatters Disease. Osgood Schlatters + Short Achilles Tendon = Pain. To Tx the Osgood Schlatters I was sent to a Physiotherapist who gave me ‘Plié’s’ to complete, this just compounded the other injuries and problems, but as it turned out... I was deemed to be an attention seeking Child and sent off to see a psychiatrist because a girl of 15 should not be in this much pain (I was taking 15 Panadiene Forte a day and forced to be wheelchair bound). I knew my pain was real and never returned to the Psychiatrist. I eventually got better of course the Osgood Schlatters healed in a little over a year and I was out of the wheelchair too.

I am now 22 years old and the Achilles pain has never left... I have flare ups approximately twice a month with each bout lasting between 3-5 days. Once these flare ups present, I have very restricted dorsiflexion and pain that is so excruciating I cry, it is for this reason that I revert back to toe walking and I cannot bear weight in the flat foot state. The pain is specifically located over the Soleus and Gastrocnemius Muscles and runs down the length of my legs and sometimes it will also affect the area near the popliteal muscle/tendon and I also have severe pain when the sides of my Achilles Tendons are very lightly squeezed. Since I am 22 I do live a healthy lifestyle I walk for 20-30 minutes 4-5 times a week and have done so for years, so technically my body should be used to this activity. As far as footwear is concerned I don’t often wear heels instead I opt for flat shoes, when flare ups occur I have to wear high heeled shoes this in turn takes the pressure off and does not cause me much discomfort. I am not overweight as I am 166cm tall and weigh 60 kilograms, I am also a Nurse so the pain that I experience absolutely impacts my career. The pain does stop when I am resting, but as soon as I go to put my feet on the floor the pain begins again, sometimes I have to get my partner to drag me up off the couch because I know it’s going to hurt and I can’t get the strength behind me to lift myself up. My partner is a fully qualified Massage Therapist trained in Remedial Sports Massage, when he massages my legs he notes that the muscles are not tight, nor do they have knots, but for that brief moment (15 minutes maximum) I am pain free and can walk flat foot again. To manage the pain associated with this I have tried NSAID’s and Panadiene Forte but to no avail. I put up with it, so to speak.

Once these flare ups have subsided I have no pain and normal ROM and I am able to walk flat foot. I am happy to see my GP once a flare up does occur, but I am scared to go and see specialists if I am referred because the flare ups are not constant, therefore if I made an appointment to see a specialist when the flare ups are not present, I am terrified again that they are going to send me off to a Psychiatrist because they ‘cant find anything wrong’ and its ‘all in my head’.

My question is, what could this be? I have searched the internet and I know that this is not a strain, sprain or RSI as it has been ongoing for the last 14 years. I am starting to get concerned now because I am 22 and I have read that if problems like this are not rectified it can lead to a degenerate state ie complete rupture of tendons and microscopic muscle tears etc.

Thank you for all your help that you may be able to provide

Tamara