Knee pain? Just walk it off.

[ShiroKuro]

@Steve-Miller said:

SK, have you considered seeing a podiatrist? I finally did and he solved a lot of problems in one visit.

I didn't mention much because I didn't want to take over @axtremus 's thread (and the problem that shapes my shoe-needs isn't knees)...

But long story short, I have ongoing problems with my knees and feet and I'm a regular at two podiatrist's offices and an orthopedist's office. And I'm a regular at PT as well.

Some of the problems, I've been able to get under control, like plantar fasciitis, which I no longer have, yay! And I had fracture in my heel bone in 2025 which has healed. But the other problems I have are intractable.

I have a bone deformity in my right heel, close to where the achilles tendon attaches to the heel bone. That has caused chronic achilles tendinopathy (and bursitis all over the area there, but the bursitis is semi under control at the moment). My last MRI showed that there's a 5 mm interstitial tear in my achilles as well, but it's vertical and interstitial, so I'm still ambulatory. The docs say the tear is most likely because I have an enthesophyte in that spot (achilles insertion point), an enthesophyte is a kind of bone spur (that pokes up vertically at the back of the heel, not underfoot) and that bone spur is like a thorn that rubs against the achilles, preventing it from healing and possibly worsening the existing damage.

All three docs have told me that I'm not going to heal without surgery, although one of them sees me walking and says at minimum, I can wait on the surgery as long as I have the mobility that I have right now. The other podiatrist (who's also a foot surgeon) is more pessimistic and sort of pushing me to do the surgery.

But this is open surgery, with a prolonged period of non-weight bearing afterward, possibly 3 months, with full recovery said to take a year.

And I am not convinced that the outcome of this surgery is guaranteed enough to make it worth the risks, and the collateral damage that the prolonged recovery entails.

So yeah, to answer your question, I do see a podiatrist

[ShiroKuro]

To bring it back to the OP, and the pros and cons of surgery... I feel like this is quite similar to the knee issues. There are tendons involved, and bone, and the traditional surgery, which is open surgery, has so many possibilities for complications, while the newer, minimally invasive surgical option is controversial and has fewer skilled/experienced practitioners...

I don't know if there are longitudinal studies (like 10 years post-op) of this surgery (I have looked before and will do so again) but I wouldn't be surprised if the findings turn out to be similar to the knee surgery findings.

Tendons heal very slowly. But the standard medical guidance is surgery if conservative measures don't show results after 6 months. If tendons heal so slowly, why wouldn't it take longer than 6 months?

Right now, I can walk. If I have the surgery, I won't be able to walk for probably 6 months. So why hurry?

So my current approach is to change the angle of my heel (with footwear and heel lifts) to move the bone and enthesophyte away from the achilles tendon, while also doing specific kinds of PT, and see if I can get better without the surgery. (so as you can guess, this is why footwear is so important to me!)

My last MRI was in May, so I'm going to ask for another MRI in next spring.

[ShiroKuro]

At present, these are the closest to perfect-for-me shoes that I've found (I add a heel lift) but they need a slightly larger toe box).

Made by Dansko

I have three pair, and right now, the black seems to be sold out, hopefully that doesn't mean they're going to stop making them...