Achilles Tendonitis & Podiatry

The most common form of injury to the Achilles tendon (located at the back of the ankle joint) is called Achilles tendonitis, which is an inflammatory condition causing pain in the Achilles tendon. Achilles tendonitis generally occurs in people who are active in sports activities. Types of sports that commonly are associated with Achilles tendonitis are basketball, tennis, running, football, soccer, volleyball and other running and jumping sports.

Achilles tendonitis tends to occur more frequently in older athletes than in younger athletes. As a person ages into their thirties and especially into their forties and fifties, the ligaments and tendons of the body tend to lose some of their stretchiness and are not as strong as before.

Diagnosis

Achilles tendonitis is diagnosed by a history and physical examination of the patient who describes pain at the back of the ankle with walking and/or running activities. The pain generally will be associated with an increase in running or jumping intensity or frequency.

During the physical examination, the Podiatrist will feel and push lightly around the Achilles tendon to see if it is tender or has any irregularities in its surface. Achilles tendinitis may cause the tendon to be thickened in areas, may cause swelling of the area around the tendon, and can even feel like the tendon has a painful bump on it. In addition, the person with Achilles tendinitis will limp while barefoot, but walk more normally with heeled shoes on.

Treatment

Achilles tendonitis generally responds very well to conservative treatment as long as it is diagnosed and treated early by a Podiatrist. Surgery is rarely indicated unless the Achilles tendonitis is particularly severe and chronic, or if the tendon has ruptured completely.

Initially, the podiatrist may treat the Achilles tendonitis by putting heel lifts into the patient’s shoes. In addition, the patient may be asked to avoid barefoot walking or walking in low-heeled shoes. Non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen may also be prescribed to calm the inflammatory process in the tendon. Icing may be suggested to help decrease the inflammation and pain in the tendon. Stretching exercises for the calf muscles may also be given to the patient to help loosen the calf muscle and Achilles tendon so that the tendon is not under as much stress during normal daily walking activities. The stretching should not be done however if it causes pain in the Achilles tendon.

If normal return to activities is not possible within a few weeks, then many times the podiatrist may additionally prescribe hands on treatment and/or custom foot orthotics to help the tendon heal more rapidly. The foot orthotics generally are used during both the sports activities and walking activities to allow for more normal foot and Achilles tendon function.

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