Inflamed Bursa (Bottom of foot)

At the end of the track season (Late may) I developed some platar fascia pain which I believe was mainly caused by going from track spikes directly into football cleats which is something I have not done in years. I’m sure doing change of direction work also caused it since I have only been running in straight lines since 2005. Anyhow the pain got really bad and I stopped running and was unable to play football.
I tried everything from Stretching, Massage, Micorcurrent, Accupuncture, DMSO, orthotics, Strengthening plantar fascia… with no luck. I finally decided to just rest it pretty much the entire summer and did no running. The pain was/is 90% gone however I still had pain right where the heel begins which hurts when standing on it barefoot and when it is palpated.
I went to the dr. last week. He did a xray which was negative for a heel spur. Did a ultrasound which showed 3mm of inflamation on my injured foot compared to my healthy foot. He gave me a shot of cortizone which did nothing and I went back today for another shot and he said the next step may be Shockwave Treament which insurance doesn’t cover and will run up to $900.00. Thoughts?
Also pain does not seem to hurt when plantar flexing and I’m not sure if it hurts running but I suspect as soon as I start running it will flare up so its better I take care of this problem before I being training for indoor.

I would hesitate to spend that much without trying a few more things first.

I had it brutally for months. I finally got rid of it with the following routine.

I know that you tried massage and stretching, but you didn’t mention icing which is key.

The other thing is if it feels a little better stay with the routine long after you think it is gone…

Follow this twice per day (morning and evening).

  1. 5 mins: massage entire bottom of foot with power massager (kind with two golfball size knobs on end). Pull back the ball of the foot and toes to stretch the plantar while massaging well. If the plantar is tight it will stand out and be tight while stretched. Rub in and around the heel as well.

  2. 2-5 mins: place a board lying up some stairs to create a 30-45 degree “calf board”. Put your foot on the board, and lean the knee forward to stretch the achilles and foot. Then lean the hip forward to stretch the calf. Tightness anywhere along the chain will cause pain in the plantar and heel.

  3. 10 mins: place foot firmly on ice pack. note do NOT strech immediately after icing. If PF is particularly bothersome then ice after training as well.


Have you tried the band method that D. Hartzell and Jump Stretch recommend? I saw him rave about helping/curing p.f. this summer at the Juniata NSCA summer clinic this June… It may be far fetched, but it’ll only cost you a band and a phone call to Ohio…

Good luck!

Do you know what the exact diagnosis is? Plantar fasciitis is such a garbage term these days; it is subcalcaneal bursitis (usually a throbbing type pain) or plantar fasciosis (chronic fascial damage). Usually I suspect bursitis in people who have had it for a while and have done everything right. Cortisone usually helps, but most of the time, just a long process of resting and allow the inflammed bursa to heal is the key. I would be interested to know the location of the inflammation in the ultrasound also.

Good recommendations. If it was plantar faciitis(sp) that would be dead on. You have summed up everything I have read pretty well and took the time to write down an exact perscription and I appreciat that. However the problem that exists is no longer the plantar fascia and it actually the bursa way back towards the heel. Massaging it actually makes it worse for days. I have stretched the shit out of it as well with no relief and forgot to mention I have iced it with ice packs and ice massage with water bottles, did some constrast as well as using chinese herbs.

As I said it is the bursa way back on the heel…from what you have seen do you think dick hartzels band method may still be applicable? It doesn’t seem like any type of strething or strengthening will do anything to fix the problem.

I agree. It is an inflamed bursa. I am having trouble finding the term Subcalcaneal online although I think that may be it. It is right where the arch ends and the heel begins (right where the calcaneus begins). When palpated it feels" squishy" in 2 spots.

What’s up? I was talking to Kerry about this at the MAC champs and I told her that I had it for 18 months on and off. It was so bad I could not walk in the morning. It was so bad at one point, I had to crawl on my hands and knees after a tempo session to rest until felt good enough to walk to the car. Anyway I tried cortisone shots with a needle that looked like a harpoon LOL!!! and spent $350 on orthotics and got active release on my feet and nothing seemed to work. I got so desprate that I started thinking about that shockwave therapy. But when I looked into it it puts you out of commision for a while and its not garunteed. Finally, I just went with my gut instinct and did some painful self massages on my calf with that kit from and used a tens unit directly on the area that hurt. In a few weeks It felt MUCH better. Not sure if this will work but you could try before blowing 900 bucks on something that might not work… Another thing that helpmed as well was not wearing hard flat shoes that would flare it up instantly. Not skater shoes but like hard flat dress shoes with no lift… like mocasins or loafers…

Here is the article that helped me:

Im no physical therapist but, what they write on this article sounds reasonable and it worked for me.

Hurry up and heal so you can get a couple more PRs this year!!!

I had heel pain for years and tried allsorts. An exercise which worked for me, which is worth a try, is heel sits.

Basically just kneel down fully so your backside is resting on your heels, then pull up on your knees with your hands with a movement that would appear to stretch your shins.

This gave me a great stretch all along the bottom of me feet. It may or may not work, as our pains sound different, but its worth a try.

Hey Man. Good to hear from you. Hope all is well. So the cortisone shots did nothing?
What did you order from that site? Was it the roller thing and ball or both? Can’t I use a foam roller to roll out those areas?

Thanks. I’ll try it. Perhaps increasing ROM in the front of the ankle may help since it does seem that area is tight.

Cortisone did nothing at all. Active release was a huge disappointment too…

I just used the small roller on the outside of my calves and my achillies on one of those yoga blocks. FYI it hurt but it was worth it :slight_smile:

After much research it is infracalcaneal bursitis

Tptherapy is good stuff. The owner is for real.

I have real problems with tightness in the front of my ankle/top of feet which cause me heel pain when I dont perform this stretch enough.

How is the pain? Have you tried the exercise?
I do it for 1min holds x 5.

I’ve done it a little b4 my foam rolling sessions. Can’t tell what has helped (the injection, foam rolling or stretching) but I went back to the dr. today and according to the ultrasound the inflamation was down from .55 to .30 on my injured foot compared to .22 and .24 respectively on my healthy foot. I actually warmup up and did ext tempo as well and had no pain. We’ll see how it feels later and tomarrow.

QFT. I have recently been having a similar problem and doing this trigger point therapy (I use a lacrosse ball and a few books for elevation) has really helped.

Another thing to consider: have you changed your sprint spikes recently? I had been using ones with a 3/4 plate. I recently changed to a shorter spike plate and started having pain. Could be a coincidence, but I’ve gone back to the old spikes just in case.

Is the trigger point theapy you are doing equivalent to what I have been doing with the foam roller basically rolling the shit out of my posterior tibialis, gastroc and soleus…
I haven’t worn spikes since may when I got the injury.

did the injury happen in fb?

I have been doing pretty much exactly what is described on the web site. I think using a ball helps provide more concentrated force on the trigger points. It hurts while I do it but it is kind of a good hurt if you know what I mean.

I was wondering if changing spikes was what caused the injury. i.e. were there any changes to your set up or program in the weeks before you noticed the pain?

What caused the injury was going directly from doing my track workout in spikes to putting on football cleats and starting practice not even 20 mins after my track workout. I have not worn cleats in 5 years and had not done any Change of direction work. After 2 practices my plantar fasica got inflammed and I still decided to fight through it in a track workout until it became unbearable one day. I was then unable to walk normally for 3 days. After the plantar fasica pain somewhat went away I was left with what I now realize was an inflamed bursa.