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The Lounge>Eric Berry has a Haglund’s deformity on his heel
DaFace 01:06 PM 09-29-2018
Yes, it's in the other thread. Bite me.

https://www.arrowheadpride.com/2018/...ty-on-his-heel

REPORT: Eric Berry has a Haglund’s deformity on his heel
New information on Berry’s sore heel injury emerged on Saturday.

By Pete Sweeney Sep 29, 2018, 1:15pm CDT

Eric Berry has not practiced or played for the Kansas City Chiefs since August 11 in St. Joseph, Missouri, because of what the team has described as a “sore heel.”

The last we heard from the Chiefs athletic training staff was in early September, when head athletic trainer Rick Burkholder described the injury as “literally day to day.”

More information on Berry’s injury emerged Saturday morning, via NFL Network’s Mike Garafolo:

Mike Garafolo: “My understanding, and I’ve spoken to people familiar with his injury situation. He’s got what’s called a Haglund’s deformity in that Achilles. That’s a bone spur that basically digs into the Achilles. Shaun O’ Hara, our colleague at NFL Network, he had it. I spoke to him this week. He said it is extremely painful. He actually used a more colorful word that I won’t use here. It’s just something that continues to irritate the area. Some guys have been able to play with it—you get a shoe here or there, you can adjust … but that’s what’s going on. It’s going to be a pain management thing. It’s not like this thing will tear the Achilles necessarily. A lot of these cases don’t result in a tear, but that’s why with Berry right now, he has not played, and they’ve been doing OK. That’s going to allow them a little bit more patience with Berry, but it is extremely painful.”

This provides a little more clarity than Berry’s injury simply being a “sore heel,” which is good, but what’s bad is there still seems to be no timetable. Remember, Berry missed nearly the entirety of the 2017 season due to a ruptured Achilles on the other leg.

Chiefs head coach Andy Reid was mum on the injury when asked about it Saturday afternoon after the Chiefs’ final practice of the week.

Berry is officially ruled doubtful heading into the Monday night game against the Denver Broncos.

----

Here are the notes from our in-house medical expert, Aaron Borgmann:

A lot of talk today regarding something known as a Haglund’s deformity. It was reported by a media source that the player in question suffers from this condition. This discussion is not to confirm or deny that possibility, as I can only explain the available information that we have been given. To be clear, the team has not confirmed this diagnosis and I have no advance knowledge of the player’s current condition.

The simple explanation here that it is indeed a bone spur on the backside of someone’s heel. This is frequently known as a “pump bump” from the occurrence that it is often seen in women’s fashion from the shoes that they wear. However, incidence in football players is also common, sometimes referred to as “retrocalcaneal bursitis” as well.

The bone spur irritates the bursa (fluid-filled sac) that sits between the bone and the tendon or even the tendon itself directly. This can cause a great deal of inflammation and discomfort with any sort of dynamic ankle/foot movement, worse with pressure on the spot itself.

Having one in and of itself it not uncommon, but the degree to which it bothers someone is the issue. Depending upon demands of movement, these can range from debilitating to just a nuisance. Obviously, in football players, the degree of inflammation is what dictates the level of function.

These are diagnosed both visually and radiographically and it is a situation where if you see it and player complains of certain symptoms (pain with movement in that exact spot, swelling, redness) then you can be pretty sure that is what it is.

Treatment focuses on reduction of inflammation obviously directly over the spot. This can be done both topically and through systemic medication. Soft tissue lengthening in both the calf and bottom of the foot is also done to alleviate the issue from both sides – this is due to the fact that both the calf and plantar fascia connect to the calcaneus (heel bone) on either side.

Not to be forgotten is footwear modification and adjustment. Very rigid shoes can cause this irritation, and in some athletes, I would even cut the shoe in the heel to allow room for the bump. Other options include specialized padding and friction reduction methods. Heel lifts have been shown to be helpful in some.

For this condition, non-surgical intervention is preferred to reduce the inflammation as opposed to surgical due to the immobilization period.

If the inflammation can be reduced and the function level high, many players learned to adapt their daily routines to accommodate. They may have to put in a bit more time in order to get ready due to the condition’s demands but can nonetheless get by and still perform at a high level.
[Reply]
FAX 04:21 PM 09-29-2018
Who is this Haglund guy, anyhow? Has he ever played football? Is he an all-pro? Has he intercepted 2-point conversions to seal a win by 1? I think not.

I say we should not let this dude and his quote/unquote "deformity" bring us down.

Screw Haglund and the deformity he rode in on.

FAX
[Reply]
Mecca 04:21 PM 09-29-2018
Originally Posted by RunKC:
Read the tea leaves:

-Chiefs obviously knew about this for weeks.
-Pretty clear that Berry so far doesn’t want/need surgery.
-getting better every week=inflammation is slowly going down.

I think he’ll play around mid season. Early November
As soon as he starts putting pressure on it again everything will return....he's delaying surgery because he could be a career ender and he has a ton of money left on the table he wants.
[Reply]
thegame214 04:21 PM 09-29-2018
Originally Posted by RunKC:
Read the tea leaves:

-Chiefs obviously knew about this for weeks.
-Pretty clear that Berry so far doesn’t want/need surgery.
-getting better every week=inflammation is slowly going down.

I think he’ll play around mid season. Early November
God I wish I saw what you're seeing. I think they're holding off as long as they can before they trade for Thomas. If Seattle knows he's done then the asking price increases.
[Reply]
chinaski 04:22 PM 09-29-2018
Originally Posted by FAX:
Who is this Haglund guy, anyhow? Has he ever played football? Is he an all-pro? Has he intercepted 2-point conversions to seal a win by 1? I think not.

I say we should not let this dude and his quote/unquote "deformity" bring us down.

Screw Haglund and the deformity he rode in on.

FAX
See my pic earlier in the thread. That's Haglund. He isn't a football player, he's a conspiracy theorist that regularly works with a certain FBI agent(s) regarding government coverups etc. :-)
[Reply]
Easy 6 04:23 PM 09-29-2018
Originally Posted by Mecca:
As soon as he starts putting pressure on it again everything will return....he's delaying surgery because he could be a career ender and he has a ton of money left on the table he wants.
This, unfortunately
[Reply]
Superturtle 04:23 PM 09-29-2018
Originally Posted by Mecca:
Because for an athlete that relies on speed and quickness the idea that he would possibly have to have his achilles detached during that surgery...

If he has 2 surgically repaired achilles that may be it for him so he probably is doing everything he can to avoid that scenario.
Then he has to accept the fact that he's playing with chronic pain for the rest of his career and he needs to get out there.
[Reply]
-King- 04:26 PM 09-29-2018
Am I the only one that took this as good news? Basically the only reason he isn't playing is because we don't need him yet. Once we need him, they'll just shoot him up with pain medication and he'll play that way. Then get surgery in the off-season.
Posted via Mobile Device
[Reply]
The Pest 04:29 PM 09-29-2018
Retire and be done with it. He was a great player but his time is over unfortunately.

Trade for Earl Thomas and move forward. Maybe we can get Berry a ring before he’s gone.
[Reply]
FAX 04:29 PM 09-29-2018
Originally Posted by Mecca:
Because for an athlete that relies on speed and quickness the idea that he would possibly have to have his achilles detached during that surgery...

If he has 2 surgically repaired achilles that may be it for him so he probably is doing everything he can to avoid that scenario.
Perhaps it's time for a refresher course, Dr. Mecca.

The endoscopic technique used to correct this problem does not require "detaching" the achilles tendon. And the likelihood that the tendon would be accidentally detached during surgery is practically non-existent.

To wit:

A proximal posterolateral portal (PPLP) is first established directly lateral to the Achilles tendon and 5-cm proximal to the Achilles tendon insertion. A 0.5-cm long vertical incision is made through the skin. Care is taken to incise only the skin, and the subcutaneous tissue is spread with a mosquito clamp. Then a blunt trocar is inserted distally to the retrocalcaneal space. After blunt dissection of the adipose tissue anterior to the Achilles tendon, a 4-mm, 30° endoscope is introduced to the retrocalcaneal space. The inflamed retrocalcaneal bursa is then identified.

To make two distal portals—a distal posteromedial portal (DPMP) and a distal posterolateral portal (DPLP) — a spinal needle is inserted directly adjacent to the Achilles tendon at the level of the superior aspect of the calcaneus under direct visualization. Instruments are introduced through the DPMP or the DPLP and visualized through the proximal posterolateral portal (PPLP). To have a better visualization, the excision of inflamed retrocalcaneal bursa is performed using a 4-mm shaver through the DPMP. If necessary, excision is done again through the DPLP.

FAX THE LAY-INTERNIST
[Reply]
-King- 04:29 PM 09-29-2018
Originally Posted by Mecca:
As soon as he starts putting pressure on it again everything will return....he's delaying surgery because he could be a career ender and he has a ton of money left on the table he wants.
Or because like California chief said, surgery could rule out playing any time this season. If it's a pain management issue, he'll play later on this season and in the playoffs
Posted via Mobile Device
[Reply]
RunKC 04:31 PM 09-29-2018
Originally Posted by -King-:
Am I the only one that took this as good news? Basically the only reason he isn't playing is because we don't need him yet. Once we need him, they'll just shoot him up with pain medication and he'll play that way. Then get surgery in the off-season.
Posted via Mobile Device
I agree but he needs to do something about his contract. Another recovery from a surgery in a year he’s making $16.5 million just can’t happen.

ACL, cancer, Achilles, bone spur.

4 surgeries on a 30 year old player just doesn’t bode well.
[Reply]
Mecca 04:32 PM 09-29-2018
Originally Posted by FAX:
Perhaps it's time for a refresher course, Dr. Mecca.

The endoscopic technique used to correct this problem does not require "detaching" the achilles tendon. And the likelihood that the tendon would be accidentally detached during surgery is practically non-existent.

To wit:

A proximal posterolateral portal (PPLP) is first established directly lateral to the Achilles tendon and 5-cm proximal to the Achilles tendon insertion. A 0.5-cm long vertical incision is made through the skin. Care is taken to incise only the skin, and the subcutaneous tissue is spread with a mosquito clamp. Then a blunt trocar is inserted distally to the retrocalcaneal space. After blunt dissection of the adipose tissue anterior to the Achilles tendon, a 4-mm, 30° endoscope is introduced to the retrocalcaneal space. The inflamed retrocalcaneal bursa is then identified.

To make two distal portals—a distal posteromedial portal (DPMP) and a distal posterolateral portal (DPLP) — a spinal needle is inserted directly adjacent to the Achilles tendon at the level of the superior aspect of the calcaneus under direct visualization. Instruments are introduced through the DPMP or the DPLP and visualized through the proximal posterolateral portal (PPLP). To have a better visualization, the excision of inflamed retrocalcaneal bursa is performed using a 4-mm shaver through the DPMP. If necessary, excision is done again through the DPLP.

FAX THE LAY-INTERNIST
I understand that, the issue would be how bad his spur is and if it can be done with that kind of surgery.

For example I ruptured a tendon and I had an open surgery to have it repaired had they tried to scope me it wouldn't have been repairable because it was worse then expected.
[Reply]
DaFace 04:33 PM 09-29-2018
Added new commentary from medical expert to the OP. There's a diagram at the link, so give them a click, will ya?
[Reply]
Superturtle 04:34 PM 09-29-2018
Originally Posted by DaFace:
Added new commentary from medical expert to the OP. There's a diagram at the link, so give them a click, will ya?
So it's preferred to not have surgery for this.
[Reply]
Mecca 04:37 PM 09-29-2018
Originally Posted by Superturtle:
So it's preferred to not have surgery for this.
It's always preferred to not have surgery if there are non surgical options.
[Reply]
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