Achilles Tendonitis is a painful condition affecting the Achilles tendon. The Achilles tendon transfers forces equivalent to four to eleven times your body weight when running. Unfortunately, the body is not always able to tolerate that much force and the result is a painful Achilles tendon.
The most painful spot will usually be one to two inches above the heel. Initially (acute phase), a sheath around the tendon becomes inflamed, as the condition persist the inner substance of the tendon actually changes in structure resulting in weakness and pain (this is no longer an inflammatory condition).
- See Principles of Recovery.
- A heel lift will help decrease strain on the tendon and should be worn in your shoes throughout the day. A heel lift is most effective during the first two weeks of symptoms. I prefer Tulli heel cups.
- Physical therapists can apply a treatment called iontophoresis, which is the use of an electrical current to apply a steroid medication over the inflamed tissue. Research has shown this to be an effective treatment to decrease pain more quickly in acute Achilles tendonitis.
- Ice is most important during the first few weeks. Chronic Achilles tendonitis is not an inflammatory condition and requires a different treatment approach.
- Insoles or orthotics (custom foot supports) may be able to position the foot in a way that reduces rotational forces on the tendon.
- Stretching of both calf muscles at least twice per day. See bent knee calf stretches and straight knee calf stretches.
- Proper strengthening of the calf muscles can actually reverse the structural changes associated with chronic Achilles tendonitis. Try standing on the edge of a step, slowly lower your heel over the edge, and then return to the start position. Emphasize the lowering phase of this exercise. Perform this exercise with the knee straight and then with it slightly bent. This exercise is presented as part of the sequence in The Injured Runner – A Balanced Solution.
- For chronic achilles tendonitis a new massage technique called ASTYM may be helpful.