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:

Eric Berry’s injury update. He has a bone spur that digs into the Achilles’ tendon. pic.twitter.com/Mw9i2RDKNV — Shelly S (@KcChiefs1972_) September 29, 2018

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.