Achilles tendinitis is an overuse injury
common in many sports that require lots of running and jumping. Once this condition becomes more chronic adhesions that form along the tissues and the injury becomes more of a tendinosis. Treatment
for a tendinosis is much different that for a tendinitis, so it is important to recognize what stage the injury is at in order to treat it appropriately. An acute achilles tendinitis involves
inflammation and would be treated with rest, ice, etc. Once the inflammation has decreased, research shows that eccentric exercises are beneficial. Once there is tendinosis, it becomes imperative to
break up those adhesions with ART and prescribe appropriate stretches and exercises.
Excessive exercise is a common cause of Achilles tendonitis. This is particularly true for athletes. However, factors unrelated to exercise may also contribute to risk. Rheumatoid arthritis and
infection are both correlated with tendonitis. In general, any repeated activity that strains the Achilles tendon can contribute to this problem. Here are a few possible causes, jumping into an
exercise routine without a proper warm-up, straining calf muscles during repeated exercise or physical activity, playing sports such as tennis that require quick stops and changes of direction,
wearing old or ill-fitting shoes, wearing high heels every day.
Symptoms include pain in the heel and along the tendon when walking or running. The area may feel painful and stiff in the morning. The tendon may be painful to touch or move. The area may be swollen
and warm. You may have trouble standing up on one toe.
The doctor will perform a physical exam. The doctor will look for tenderness along the tendon and pain in the area of the tendon when you stand on your toes. X-rays can help diagnose bone problems.
An MRI scan may be done if your doctor is thinking about surgery or is worried about the tear in the Achilles tendon.
In order to treat achilles tendinitis effectively, it is important to complete a thorough examination of the entire lower extremity. Once the true cause is identified, a comprehensive treatment
program can be initiated to reduce inflammation and improve any faulty lower extremity biomechanics. Treatment options may include biomechanical analysis of gait. Splinting/bracing to alleviate the
strain on the tendon. Soft tissue mobilization/manual therapy to decrease inflammation and promote healing of the tendon. Strengthening/flexibility and proprioceptive exercises. Home exercise
program. Modalities for pain and inflammation (i.e. ultrasound, iontophoresis, electrical stimulation, ice). Methods to alter faulty mechanics (i.e taping, orthotics). Education about lifestyle
changes (i.e. proper shoes, activity modification).
Most people will improve with simple measures or physiotherapy. A small number continue to have major problems which interfere with their lifestyle. In this situation an operation may be considered.
If an operation is being considered, the surgeon will interview you and examine you again and may want you to have further treatment before making a decision about an operation. Before undergoing
Achilles tendonitis surgery, London based patients, and those who can travel, will be advised to undergo a scan, which will reveal whether there is a problem in the tendon which can be corrected by
surgery. Patients will also have the opportunity to ask any questions and raise any concerns that they may have, so that they can proceed with the treatment with peace of mind.
Wear shoes that fit correctly and support your feet: Replace your running or exercise shoes before the padding or shock absorption wears out. Shock absorption greatly decreases as the treads on the
bottoms or sides of your shoes begin to wear down. You may need running shoes that give your foot more heel or arch support. You may need shoe inserts to keep your foot from rolling inward. Stretch
before you exercise: Always warm up your muscles and stretch gently before you exercise. Do cool down exercises when you are finished. This will loosen your muscles and decrease stress on your
Achilles tendon. Exercise the right way: If your tendinitis is caused by the way that you exercise, ask a trainer, coach, or your caregiver for help. They can teach you ways to train or exercise to
help prevent Achilles tendinitis. Do not run or exercise on uneven or hard surfaces. Instead, run on softer surfaces such as treadmills, rubber tracks, grass, or evenly packed dirt tracks.