Recently signed Phillies pitcher Chad Qualls is currently resting in the dugout because of a mysterious heel injury.
This week, only three games into the season, Qualls had to pull out because of foot pain that he said felt like a “knife was going at the back of my heel.”
Qualls is not exactly sure how he sustained the injury.
Dr. Silverman Comments
The most likely cause of posterior heel pain with an acute onset (like what Qualls is experiencing) is retrocalcaneal bursitis. This is an inflammation of the region in front of the Achilles and behind the calcaneus (heel) bone.
It is thought to be caused by a tight calf muscle and a larger posterior calcaneal process. If left untreated it can lead to insertional Achilles tendon degeneration and tearing.
Rest, Modalities such as ice and ultrasound, and anti-inflammatory medications like Motrin or Naprosyn can calm the inflammation. Physical therapy to stretch the Achilles tendon will also help.
As a MN orthopedic surgeon, there are several courses of action Qualls can pursue to fix the problem. A heel lift may relieve stress on the bursa in front of the tendon. In recalcitrant cases, a cast boot will resolve the pain, but this also weakens all the leg muscles and is too damaging for most athletes. If the pain is recurring and interfering with the activities of life, heel surgery is the best course of action.
With the limited information in this article, I expect that Qualls will improve rapidly with some rest rapidly. His doctors will be most concerned with working to prevent recurrence.
Related Sources:
NBCnews.com