Achilles Tendonitis? Why You Can’t IGNORE It



The Achilles tendon is a specialized material located at the back of the leg. It connects your calf muscle to your heel and is a visible cord just behind the ankle. It is largely responsible for our speed and power through the legs. Achilles tendonitis is a common injury among the mid-’30s to mid-50-year-old athletes.

When you find yourself with Achilles tendon problems you should NOT “work” through the pain. This increases the likelihood of a total tear, will delay recovery, and may permanently affect athletic performance (for any running, jumping, or direction-changing sports…. Like tennis, pickleball, basketball, etc).

Too many people wait weeks and months thinking it will go away on its own. Putting themselves at risk of a full tear which requires surgery and months of rehab. When inflamed, the Achilles tendon loses some of its elasticity making it easier to tear. When you take into account the age group and how one’s feet may have a poor blood supply, this makes the issue worse.

If you are suffering from Achilles pain you have to remember there are two types of injury to this area that respond to different types of treatment. One is called insertional Achilles tendonitis and the other is called mid-belly Achilles tendonitis. Insertional Achilles tendonitis is located right on the heel bone behind the ankle.

Mid-belly Achilles tendonitis is found in the middle one-third of the tendon measuring from the insertion to the heel taper of the calf muscle. Getting the right diagnosis significantly improves your chances for a fast and safe return to activity.

Here are 3 Things You Can do to Avoid Tearing Your Achilles Tendon.

Longer Warm-Up Period

Prior to the activity, it becomes more important to improve the elasticity of the Achilles tendon. Inflammation makes the tendon more rigid. As a result, you need to spend more time with light dynamic stretches and movements that include ankle movement with the knee bent and with it straight like you see in this video. Since most Achilles tendon tears occur when the muscles are not warmed up along their full range of motion. I’ve had patients tear it stepping off a curb wrong, and even turning to rebound a basketball for their son after getting home from work. whatever you can do to keep the calf muscle and Achilles tendon warm before going into a quick move will help.

If those movements are painful, back off and start on a stationary bike for 10 minutes. Work intervals on the bike go from lower intensity for 15-30 seconds and then higher intensity for 10-15 seconds. Eventually, you should be able to do 30-45 seconds of high intensity and only 15-20 seconds of low intensity.

Stretches throughout the day

Throughout the day we often get in a rut of doing the same movements that don’t support our recovery effort and can even put us at risk for a spontaneous tear. Break that routine up and include light dynamic and static stretches 3-5 times a day with no pain. In this video, you can see how tight your ankle and calf muscles are and then perform the stretches at the end of the video 3-5 times a day to improve the length of your stiff Achilles tendon. Be sure to take note of your foot position. You want to make sure the toes are pointing straight ahead. If you want to change it up a little you can angle your toes inward as long as you avoid allowing them to migrate outward.

Choose the Correct Footwear

Footwear options for work have a lot more flexibility than ever before. Try to avoid shoes that are heeled and restrict your ankle movement but instead choose to wear low tops and flats. Avoid wearing boots, high tops, or high heels. By wearing low-top flats you will allow for a natural stretch to the Achilles throughout the day. This will help your Achilles to stay elastic and help avoid shortening of the calf muscles.

What Can Physical Therapy Do For You?

When we treat patients suffering from Achilles pain, the first thing we do is to identify what type of injury that you have. The wrong treatment can make things worse. Knowing if ankle stiffness, weak hamstrings, tight calves, tight plantar fascia, high arches, low arches, and any number of combinations therein will determine the kind of treatment we prescribe. Once we identify the type and cause of the pain our treatments will include a combination of hands-on treatments and exercise. Hands-on treatments can include joint mobilizations to loosen stiff joints, instrument-assisted soft tissue mobilization, and dry needling to influence the flexibility of the muscles and improve the mobility of the fascia. If you have any more specific questions, click the link below to schedule a phone consult.



Nick Hunter, PT, DPT

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