Even though the Achilles tendon is the strongest tendon in the human body, it’s prone to injury and in fact, Achilles tendonitis is one of the most common conditions presented in our offices.
The majority of the Achilles tendon’s attachment is to the upper back portion of the heel. Pain and/or swelling in this area or along the tendon may be caused by Achilles Tendinitis.
Several factors can contribute to inflammation and can result in Achilles Tendinitis. It typically presents with gradual onset of pain and stiffness which worsens with activity. It commonly occurs in sports such as running, dancing, jumping and tennis. Overuse associated with a change in playing surface, footwear or intensity of an activity are common causes. Sudden increases in training and excessive hill running have been shown to contribute.
If you are suffering from Achilles tendinitis, here are some important dos and don’ts to improve recovery and help prevent further damage:
Achilles Tendinitis Treatment Dos:
- It is important to abstain from activities that aggravate your pain.
- Find exercises or activities that do not irritate your Achilles tendon.
- Begin non-steroidal anti-inflammatory drug (NSAIDs) therapy such as Aleve or Ibuprofen (note: NEVER take these medications on an empty stomach as irritation or ulcers and bleeding can occur).
- Ice and massage the Achilles after activity.
- Perform warm-up and stretching exercises prior to physical activity.
- Evaluate shoe gear to assure that they provide adequate support. An orthotic or supportive insert may be necessary.
Achilles Tendinitis Treatment Don’ts:
- Do not delay treatment. Studies have shown that the longer Achilles tendinitis is present; the longer it takes to recover.
- Do not overstretch. An eccentric stretching routine is most effective. Avoid stretches that put more strain on the Achilles; such as hanging stretches or stair stretching.
- Do not “run through the pain.” Overusing the Achilles tendon causes continued damage, which may delay recovery.
- Do not pursue a steroid injection. Although corticosteroid injection therapy is effective at reducing inflammation if other parts of the body. There is evidence that injection of the Achilles tendon with corticosteroid may result in rupture of the tendon.
An appointment with a foot and ankle specialist can evaluate your gait for excessive pronation and discuss proper supportive shoe gear and orthotics. It is also important to evaluate your running technique and evaluate for tightness of the calf or equinus. Imaging such as ultrasound or MRI is useful to evaluate for a possible tear or damage to the Achilles tendon.
At University Foot and Ankle Institute we prefer conservative treatment consisting of initial rest, activity modification and anti-inflammatory medication. If necessary, walking boot mobilization is initiated. After the initial pain and discomfort calms down, aggressive eccentric stretching of the Achilles tendon is prescribed. Stretching is accomplished through use of a night splint, home stretching exercises and physical therapy.
If initial therapy fails resolve symptoms, more advanced treatments may be necessary. We commonly use PRP (platelet rich plasma) injection for stimulating revascularization and enhancing healing at a microscopic level. PRP injection therapy is a simple procedure that is performed in our institute under local anesthetic and ultrasound guidance. Our usual post procedure management includes immobilization for 2-6 weeks. Followed by ROM exercises, physical therapy, and gradual return to activity as tolerated.
The most importance factor for treatment of acute Achilles Tendinitis is not delaying treatment. An appointment with a foot and ankle specialist when symptoms initially develop reduces recovery time and facilitates quicker return to activities. If you are suffering from Achilles tendon pain, we encourage you to schedule an appointment with one of our foot and ankle experts. Please cal (877) 989-9110 or visit us at www.footankleinstitute.com
Dr. Campbell enjoys the outdoors and shortly after he moved to Southern California took up surfing. However, when the waves are flat you can find him on the golf course or riding his motorcycle.
Dr. Campbell is available for consultation at our Santa Barbara office.
Learn more about Dr. Campbell by visiting our website: http://www.footankleinstitute.com/podiatrist-santa-barbara
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