Q: I think I might have a problem with my Achilles tendon. What are some common causes of Achilles pain?
There are two primary causes of pain in the Achilles: Achilles tendinopathy and Achilles tendon tear.
Achilles Tendinopathy. Tendinopathy comes in two flavors. Achilles tendinitis is an inflammation of the tissue surrounding the Achilles tendon. Achilles tendinosis refers to tiny micro-tears in the tissue surrounding the tendon, typically caused by repeated stress and over-use. Although these are technically two different conditions, they often go hand-in-hand. Foot and ankle specialists will sometimes use tendonitis to refer to the initial stage of the pain, while tendinosis describes the chronic condition.
Achilles Tendon Tear/Rupture. A partial tear in the Achilles tendon may cause mild pain or it could be asymptomatic. A complete tear is known as a rupture, and the patient is usually in a lot of pain and is unable to move or bear weight on the injured foot.
Q: Which factors increase my risk for Achilles tendon injuries?
Achilles tendinopathy and tendon rupture are both more common in people over the age of 30. As you age, the blood tends to have a more difficult time circulating to the tendon tissues, which makes the area more susceptible to injury. Obesity can also increase your risk for Achilles injuries, and men have a stronger likelihood of injuring their Achilles than women.
Q: What can I do to prevent injuring my Achilles tendons?
You should stretch your ankle and the tendon before starting any exercise or before a hard day’s work. This stimulates the tissue and warms it up for movement and repeated stress. You can also strengthen the muscles surrounding the tendons by performing lunges, squats, calf raises, leg raises, leg presses, leg curls, and leg extensions a few times per week.
Q: When should I see a doctor?
You may have sustained an Achilles tendon injury if you:
Are experiencing severe pain in the ankle and back of your heel
Took a direct hit to the Achilles tendon
Experienced sharp pain on impact
Felt or heard your Achilles pop
Are unable to walk without pain
Have swelling in the Achilles area
Are experiencing tingling or numbness in your foot, or if your foot is blue or pale
May have re-injured yourself after a previous Achilles tendon injury
Call your doctor immediately if you think you have injured your Achilles. Until you can get to the doctor, rest your leg and do not try to play through the pain!
Q: Are there any conservative treatments for Achilles tendon injuries?
Yes! In fact, most Achilles tendon injuries can be treated very conservatively and will heal on their own with enough time and rest. You really must rest though, because putting too much stress on the tendon will delay the healing process and increase your risk of re-injury. To help your tendon heal, try:
Getting plenty of rest and elevating your leg when you’re lying down or sitting.
Using crutches when walking to take some of the stress off the injury.
Icing the area for 15-20 minutes every 3-5 hours for the first three days. This will help ease the pain and reduce swelling.
Compressing your lower leg with an Ace bandage to reduce swelling.
Asking your doctor about using a heel lift. This is a special insert for your shoes that lifts some of the strain of walking off of your Achilles.
Stretching your muscles as recommended by your foot and ankle specialist
Take over-the-counter medications to manage the pain. We recommend acetaminophen (Tylenol) to relieve the pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve) might help, but if your tendon problem does not involve inflammation, then they may not be as effective.
Q. What are regenerative treatments and how can they help Achilles injuries?
Regenerative medicine is a very exciting, relatively new medical practice that jumpstarts your body’s ability to heal itself. Using your own body’s cells, regenerative medicine can restore your tissues natural function better than traditional healing methods.
Achilles tendon patients have been seeing a lot of success with a type of regenerative medicine known as Platelet Rich Plasma (PRP) therapy. PRP therapy is a safe and all-natural healing method for damaged joints and soft tissue. It has worked wonders in treating issues with chronic pain. In PRP therapy, we take a small amount of your own blood and spin it in a centrifuge. This separates out the blood components to create a highly-concentrated new plasma specimen that is chock-full of platelets. The platelet-rich plasma is then injected into the site of the injury. Supercharged by the abundance of platelets, the cells can work harder and faster to heal the tendon.
A second type of regenerative therapy that’s been very effective is Stem Cell Therapy. Stem cells have amazing healing potential. Stem cells can multiply quickly and without limit, and they have this unique shape-shifting quality which allows them to become nearly any other type of cell in the body. The stem cells used in this type of therapy do not come from embryos – they come from the patient him or herself. In this type of therapy, the doctor will collect a blood sample from the patient, separate out the stem cells, and then customize a special concoction to treat your specific injury. The cells are then injected into the site of the injury, where they quickly start dividing and healing.
Q: What is a night brace and should I use one?
If you’re experiencing pain and stiffness in the morning, your foot and ankle specialist might recommend you use a night brace. A night brace is a device you can wear to keep your foot flexed while you sleep. Keeping the tendon stretched with a night brace prevents the microtears from healing while the Achilles is in a shortened, relaxed position at night.
Q: Does my Achilles tendon injury need steroid injections?
In some tendon or joint injuries, injections of corticosteroids can be used to reduce pain and inflammation, but doctors don’t typically recommend them for Achilles tendinopathy. They can sometimes make the injury worse and increase the risk of a complete tendon rupture.
Q: What is recovery like for an Achilles tendon injury?
Recovery time for an Achilles tendon injury varies greatly depending on the severity of your condition. The reality is that your injury could take months to heal. Generally, you can still remain active as you heal, but you may have to choose activities that don’t aggravate your injury. Your doctor can suggest some low-impact exercises that might work for you. Swimming is a popular choice. Don’t even think about returning to your previous level of activity until your injured leg can move as easily as your other leg, you feel equally strong in both legs, and you no longer feel any pain when you walk, run, or jump.
We know it’s no fun sitting on the couch, healing from an injury, but no activity is worth re-injuring yourself and risking permanent damage.
Q: Will my Achilles tendon injury need surgery?
Your foot an ankle specialist will likely want to exhaust all non-surgical options before considering surgery. However, if surgery is needed, you can rest assured that your doctors at UFAI are using the most cutting-edge Achilles rupture repair techniques in the field.
The Achilles is a delicate and complex tendon. In older open surgery techniques, the repair is performed through a single, long, vertical incision on the back of the lower leg. The surgeon pries back the skin to stitch together the ruptured ends. UFAI surgeons instead use the PARS (or percutaneous) technique, a minimally invasive state-of-the-art procedure that allows the surgeon to suture the healthy sections of the Achilles together. This results in a much stronger tendon.
Q: What is the recovery period like for Achilles tendon repair surgery?
The surgeons at UFAI utilize the PARS procedure. It is a revolutionary, minimally invasive surgery that cuts recovery time in half, increases success rates and results in less scarring. Patients are in a cast for two weeks, and at 4 weeks are fitted with a boot and can bear weight. The small incision heals within a week with minimal scarring.
Q. I just had Achilles tendon surgery. Is there anything I can put on the incision to help it heal and make it less visible?
We recommend silicone gel sheets, vitamin E cream and Mederma. All of these products can improve the cosmetic outcome of surgical incisions.
Q: Can Achilles tendon injuries come back?
Yes, there is a chance that an Achilles tendon injury or tendinopathy can come back even after a successful treatment. Talk to your foot and ankle surgeon about ways you can reduce the risk of recurrence. You should stretch and exercise your calf daily and wear appropriate, well-fitted shoes for your activities to protect your tendon from further injury.
I highly recommend Dr. Baravarian at UFAI. After months dealing with another doctor and getting no results (and a really painful cortisone shot), I was finally diagnosed correctly and had a successful surgery. I fou...
I injured my foot last night while kickboxing. I was afraid I broke it. I called Dr. Bob Baravarian's of the Foot and Ankle Institute, hoping to schedule an appointment. Luckily, they were able to see me today. I ...
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I visited Dr. Baravarian based on my primary doctors recommendation. My primary said he is the best in the business for my situation. I ruptured my Achilles Tendon on October 6th and had surgery by Dr. "Bob" on Oct...
I have been truly amazed with Dr Baravarian. I had a loose piece of bone at the base of my fifth metatarsal. Got an X-ray and an MRI right there in the building before having it surgically removed yesterday. Surgery w...
I hesitated to see a doctor because I thought I would be told to stop running... when I saw Dr. Franson, I got encouragement instead of discouragement. Suzanne at Physical Therapy not only got rid of the pain, but sh...
Dr. Franson is a lifesaver! I walked in with a lot of foot pain and walked out pain-free. I was expecting to get diagnosed and come back for another visit, but Dr. Franson quickly determined my condition and fixed me ...
Dr. Franson and the entire staff at University Foot & Ankle Institute - Valencia are awesome!! I had both feet corrected (bunion surgery) by Dr. Franson and he did amazing work!! He is caring, gentle and friendly, and...