For any of these conditions, Stretching, Arch Support and Supportive Shoes are three factors that help prevent and mitigate these injuries.
As mentioned in my post about Plantar Fasciitis, heel pain is one of the most common conditions I treat in my office on a regular basis. One of the causes of heel pain at the back of the heel and running up the ankle is Achilles Tendonitis. Like Plantar Fasciitis, this is often caused in runners by overuse and sometimes because of degeneration. The Achilles tendon is the largest tendon in the body. It connects two calf muscles to your heel bone and is used when you walk, run, and jump.
Tendonitis in this ligament occurs as a result of tiny tears in the Achilles tendon and has two forms. Non-insertional Achilles Tendonitis and Insertional Achilles Tendonitis. Non-insertional Tendonitis is a common condition in athletes of varying abilities and ages, as well as ordinary people who exercise regularly. In Non-insertional, the tendon fibers in the middle portion of the tendon have begun to break down with tiny tears (degenerate). They then swell and thicken therefor causing the inflammation and pain.
The most common causes of Achilles tendon pain are tightness in the tendon combined with overuse (too much, too fast, too different). Shoe issues can also be a cause, such as switching from normal heeled shoes to zero drop shoes without taking time to transition, or going to a shoe that is far too unstable, etc.
Home Treatment Options for Achilles Tendonitis
- Staying off your foot as much as possible and also switching to swimming or bicycling to reduce foot pressure is a good strategy
- If you haven’t caught it early and already limping from normal activity, you may need immobilization in a boot for two weeks or more
- Icing your foot – take a frozen water bottle and roll your foot over it to reduce inflammation and pain
- Stretching to reduce tightness in the tendon – some good exercises are in our free guide
- Anti-inflammatory medications – this includes a topical analgesic gel or Motrin, Advil or Aleve by mouth to bring down the swelling and reduce pain
We have put together a home care stretching and exercise guide for dealing with heel pain and Achilles Tendonitis. Use this guide as a first step to help alleviate the pain.
In Office Treatment Options for Achilles Tendonitis
If you don’t experience relief with home treatments, I offer treatments after evaluation in my office. These include:
- Taping or strapping the foot. I can apply kinesio tape, such as Rocktape, to support and reduce painful symptoms
- Physical therapy is something I can write a prescription for if home stretches are not enough. Physical therapists offer a wide range of modalities to treat this condition including ultrasound therapy. This uses sound waves to generate heat, loosening up tissue to increase response to stretching. Manual techniques such as massage of the calf muscle along the full length of the tendon can also work
- I may give a steroid injection or prescribe stronger anti-inflammatory medication
- Custom molded orthotics with a heel lift to reduce tension on the Achilles tendon
- Podiatry recommended arch supports such as Powersteps can be used in sneakers. They even have a line of arch supports for narrow dress shoes to make them more supportive for your feet
- Night splint for wearing in the evening or during sleep to passively stretch the tendon
- Additional non-invasive treatment options are available
- Surgery may even be discussed as a last resort
You can learn more about other running related injuries by checking out our Discussion Series on Running Injuries. If you have specific questions about achilles tendonitis to ask Dr. Caruso, please Contact Us here. If you would like to see the doctor please Schedule an Appointment here.