By all appearances, Vanessa Fraser’s pro running career was going well in 2020. That February, she ran her personal best of 14:48.51 in the 5,000 meters—at the time, the second-fastest U.S. indoor mark. But behind the scenes, nearly every step she took—on the track or off—brought excruciating pain in both heels.
Each morning, Fraser would soak her feet in hot water for 10 minutes to loosen them up. At times, she dreaded getting up from the couch to get a glass of water. The pain was “a mental weight at all times,” she tells Runner’s World.
Fraser, whose symptoms started in January 2017, was eventually diagnosed with insertional Achilles tendinopathy and bony growths called Haglund’s deformities. When the COVID-19 pandemic put racing on pause in spring 2020, she became one of many pro runners—including Olympians Galen Rupp, Donavan Brazier, and Karissa Schweizer—to undergo surgery to treat them. When Colorado-based physical therapist Ana Robinson, PT, DPT, learned about Haglund’s deformity in PT school, it was called “pump bump,” caused by rubbing from high heels or other tight footwear.
But over her two decades of treating athletes, she’s seen many cases in athletes, including elite and recreational runners. Insertional Achilles tendinopathy, including cases linked to these bony growths, is less common than problems higher up along the tendon. It’s often more difficult to treat, requiring months of physical therapy and sometimes surgery.
But in the long term, runners can usually get back to doing what they love, says Mark Dudek, PT, DPT, a physical therapist at Vail Health and Howard Head Sports. Don’t let an injury derail your training. Get back on your feet with the Runner’s World Guide to Common Injuries, packed with training tips, recovery guidelines, and injury knowledge from medical experts.
The terminology can get confusing because there are many potential sources of heel pain and stiffness. Haglund’s deformity refers to a bony bump that forms on the back of the calcaneus, or heel bone, says Nick Strasser, MD, assistant professor of orthopedics in the division of foot and ankle surgery at Vanderbilt University. Often, the growth rubs on or compresses the tendon, causing degeneration or what Strasser calls “a fraying effect.” Because this occurs at or near the point where the tendon connects to the bone, it’s referred to as insertional Achilles tendinopathy. (Pain and stiffness higher up the tendon, meanwhile, is called midsubstance Achilles tendinopathy.) The bursa—a fluid-filled sac that provides cushioning between your heel bone and Achilles tendon—can also become red, swollen, and painful.
Extract — continue reading at the source.
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