Pump Bump and Graston

About 7 months ago I started having classic AT problems. However, there was never any pain on the achilles itself. The pain was always at the base of my foot - it felt like a bruise on the bone when anyone applied pressure to that specific area. Before seeing a doctor I tried to treat myself with rest, exercises, stretching, etc. It didn't work so I went to a podiatrist who diagnosed me with insertional achilles tendinosis. No further follow up was needed from him so he referred me to physio. I've been going to Physio for 4 months now and there has been little change in symptoms. The only slight improvement was when I stopped running almost 10 weeks ago. I'm very close to stopping cycling as that is also causing more stiffness.

Anyway, I finally decided to see a Chiropractor who specializes in Graston. She performed an in office ultrasound scan and noticed that my Achilles seems to be in good shape, no plantar fasciitis and no inflammation. What she did notice was pump bump. There is no visible bump on my heel but was pretty obvious on the US.

Now, this is where I need a little help...She mentioned that there aren't any exercises I can do since it's a calcification on the bone that's causing the pain/stiffness. She said I need orthotics to relieve the pressure on the heel so I can get back to running. I thought she was going to try to sell me custom made ones but she was pushing the Super Feet insoles. Then she gave me 10 minutes of Graston Therapy.

Is she correct in any of this or am I being taken advantage of? If there aren't any exercises or therapy that can be done because it's a bone issue then why would she do Graston?

I admit that I should have asked her directly but I got really overwhelmed in her office and didn't start really thinking about what she said until I was at home. Had she been pushing custom made orthotics I would have thought for sure she was in it for money but I've heard really fantastic things about Super Feet insoles and they are relatively cheap.

Can anyone with any experience shed some light on this for me? Thanks in advance.

when you say at the base of the foot where exactly do you mean?

perhaps you need a second opinion to put your mind at rest.

The bruised feeling is located on back of my foot. If I were to point to the pain while resting my foot on the ground, my finger would graze the floor. I hope that makes sense.

Going to the Chiro was my second opinion. I first went to a podiatrist who originially diagonosed me with insertional AT. I'm not questioning the Chiro's diagnosis as it was pretty clear from the ultrasound scan. I'm more curious as to whether I should bother with Graston if it's a bone issue or just go straight to orthotics. I apologize, I probably should have phrased my questions a bit better.

i'd never heard of Graston till now, but from reading about it, it says its soft tissue manipulation, which would seem to be counter-indicated by a bone issue.

I'd go for the orthotics, but obviously am no expert!

just thinking the title of your post would make a great name for a band!

I have a physio appt tomorrow so I'll ask for her thoughts as well. She has never tried to sell me anything so I'm hoping she can provide some clarification. But, I agree with you, I'm thinking orthotics might be the only way I can run pain free again.

I know a runner who had the same problem as you. He ended up having surgery to remove the bony spurs (private health insurance funded, not NHS, not sure if they'd do it...) and after about a year of recovery is now back running marathons pain free and faster than before. He tried loads of things before opting for surgery and nothing helped. Sounded pretty brutal though as to get to the bony spurs they had to actually cut his achilles then reattach it...

Oh no, I hope that's not the case with me. Although I have tried almost everything with the exception of orthotics so I wonder if I'm headed down the same road. I managed to talk my GP into ordering an MRI so I'll go for that on Monday and get the results on Wednesday.  Not sure if it'll tell me anything different than the ultrasound scan but it's worth a shot. I'm beyond desperate for this injury to go away.