Achilles Tendonitis

What is it?

Achilles tendonitis often occurs when you rapidly increase the intensity of training or start new types of training when your body is not fully conditioned, e.g., adding uphill running to your training schedule or restarting training after a period of inactivity. In addition, the structure of the Achilles tendon weakens with age, which can make it more susceptible to injury. You may experience mild pain after exercise that gradually worsens. Mild swelling, morning tenderness, and stiffness may also occur, but may improve with use. Severe episodes of pain along the length of the tendon several hours after exercise may also be experienced.

What are the treatment options?

Because other symptoms may be present, it is best to see your doctor for full evaluation of an Achilles injury. Treatment depends on severity and typically involves rest and nonsteroidal anti-inflammatory medications (NSAIDs) to relieve pain and inflammation. An orthosis (a brace) may be needed to relieve the stress on your tendon and support your ankle, or bandages may be applied to restrict joint movement. A shoe insert or wedge that slightly elevates your heel can relieve strain on the tendon and provide a cushion that lessens the amount of force exerted on your Achilles tendon.

Surgery is sometimes an option to repair any tears and remove any inflamed or fibrous (toughened) tissues. Recovery in general includes rehabilitation to avoid future weakness in your ankle.

Risks Factors

  • Gender: Males are more likely to experience Achilles tendonitis. 
  • Age: Risk of Achilles tendinitis increases with age. 
  • Training: Running and/or walking on hilly terrain can increase risk of injury. Increasing your running/walking distance or frequency too quickly can also increase your risk. 
  • Foot Shape: A naturally flat arch of your foot can put more strain on the Achilles tendon. 
  • Medical conditions: People who have psoriasis or high blood pressure are at higher risk of developing Achilles tendinitis. 
  • Medication: Certain types of antibiotics, called fluoroquinolones, have been associated with higher rates of Achilles tendinitis.

Rehabilitation Plan- Exercises

Rehabilitation is a typical treatment option for Achilles tendon inflammation and can help to decrease pain and allow for gradual return to normal activity.

For Achilles tendonitis, the following treatments are often utilized:

  • Strengthening exercises to regain strength that may have been lost while the tendon was healing 
  • Eccentric strengthening exercises to help lengthen the tendon and strengthen it as it heals 
  • Stretching and flexibility exercises to improve range of motion that may have been lost 
  • Ultrasound deep heat therapy to improve circulation which may aid in the healing process 
  • Iontophoresis treatment to introduce an anti-inflammatory directly to the site of inflammation 
  • Deep tissue massage or dry needling treatment to improve circulation, decrease soft-tissue restrictions and improve flexibility. 

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