Achilles Tendinitis

Achilles Tendinitis

What is the Achilles tendon?

The Achilles tendon is one of the strongest in the body. It attaches to your heel bone and lifts your heel off the ground when you are walking, dancing, jumping or running.

What is Achilles tendinitis?

Achilles tendinitis is a common problem that causes pain at the back of the leg near the heel. There are several types of Achilles tendinitis.

The tendon can be inflamed in the outer part of the tendon and often appears swollen, it is painful to squeeze with your fingers and can be painful when you are walking or running.

The centre of the Achilles tendon can degenerate or have tears. This type of Achilles tendinitis is more painful.

The heel bone can develop bone spurs where the Achilles tendon joins the bone. This is called insertional Achilles tendinitis.

 What causes Achilles Tendinitis?

Achilles tendinitis can occur for several reasons:

• Tendon tightness.
• Training too hard, you are doing too much too soon.
• Walking for much longer than you are normally accustomed too.
• Heavy lifting.
• Standing for many hours.
• Poor ankle and foot alignment for example when your ankle or the arch of your foot rolls inwards.
• Calcaneal (heel) bone spurs.

X-rays

An X-Ray will show if there are heel spurs present causing your pain. Sometime the X-Rays show areas of calcium in the tendon that can also cause pain.

MRI or Ultrasound

• It may take a few months for an Achilles tendinitis to completely recover. Even with early treatment, the pain may last longer than 3 months.

• If the diagnosis indicates it, Fitter Feet for Life offers Shockwave Therapy. Bursts of sound waves from compressed air help increase bloodflow to the affected area and stimulate regeneration and healing.

• Resting by decreasing activities that irritate the tendon is the first step to recovery. The impact of too much walking or running can make it worse. Consider doing exercise that doesn't strain the Achilles tendon so much. for example, cycling, using a cross trainer or swimming.

• Applying an ice pack on the most painful area of the Achilles tendon is helpful to reduce pain and swelling. Apply the ice over a sock or tea-towel to protect the skin for up to 20 minutes once or twice a day. Remove the pack if the area becomes numb.

•  Steroid injection can help Insertional Achilles tendinitis. A steroid injection is a powerful anti-inflammatory medication and can relieve pain and swelling around a heel spur. Steroid injections into the Achilles tendon is not recommended because they can cause the tendon to rupture or tear.

• Foot orthoses can be made to hold the heel and leg in good alignment, this reduces the stains on the Achilles tendon caused by poor alignment and helps the tendon recover.

• Pain from insertional Achilles tendinitis can helped by shoes with softer heel counters and silicone heel lifts reducing the pull of the tendon.

• Physiotherapy. The Fitter Feet for Life Physiotherapist can provide Calf stretches but also examine other muscle groups that may be contributing to the problem, for example tight hamstrings and a tight plantar fascia in the foot, will make the Achilles tendinitis worse.

• If your pain is severe, we may recommend a Medical style walking boot for a short time. This reduces the load to the tendon allowing healing to take place in order that you move on to physiotherapy as soon as possible. Warning: Wearing the Boot for too long can ultimately weaken the calf muscle.

• Class 3B Cold Laser is non-invasive—it does not require a surgical incision. It encourages blood flow and the repair of the tendon.

Surgical Treatment

Surgery should be considered to relieve Achilles tendinitis only if the pain does not improve after 6 months of nonsurgical treatment. The specific type of surgery depends on the location of the tendinitis and the amount of damage to the tendon.

What should I do next?

Try stretching your Achilles tendon and wear supportive shoes for two weeks. If you are not better after doing your stretches please phone and book a consultation for “Gait analysis.” we will examine you, film you walking and start your treatment. Click here to see more about gait analysis.

If you are a runner make sure your stretch before and after running and wear the correct running shoes. Have a look at our leaflet on how to choose the correct running shoes.