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24-yr old international level athletic (runner: 800 and 1500m) has had heel pain for about a month. MRi shows swelling under the cortical bone in calcaneus laterally near the insertion of achilles tendon. Has been resting for two weeks, when starts to run carefully the pain appears in a similar way than before the resting period. Had one year ago pain in about same area, MRi at that point didn`t show any changes in bone tissue but soft soft tissue swelling near the insertion of achilles tendon. Got one cortison shot without help. Question: should I suspect a stress fracture or achilles tendon insertitis causing the bone inflammation? Would you recommed this time a cortison shot in the area of the pain on palpation or should he still keep his foot in rest (with stretching of the achilles tendon)?

 

Hi Martti, if you repost this is a biomechanics forum you will be inundated with advice! :)
2 weeks rest is unlikley to allow for healing.
I look forward to reading further replies ;-)

cheers