NON-INSERTIONAL ACHILLES TENDINITIS

NON-INSERTIONAL ACHILLES TENDINITIS

Achilles tendinitis is a common cause of posterior heel pain. Patients who have this often also have had plantar fasciitis in the past. This is because the cause is similar. Fortunately, many cases are able to be treated without surgery.

The Achilles tendon is the largest tendon in the body. Tendinitis is inflammation of this tendon, which can be caused by overuse, shoe rubbing, inflammatory disorders, a particular shape of the heel bone, and tight calf muscles. The body responds to micro-tears in the tendon by laying down scar tissue. This causes permanent thickening of the tendon, which is often mistaken for swelling.

NON-INSERTIONAL ACHILLES TENDINITIS
NON-INSERTIONAL ACHILLES TENDINITIS

Nonsurgical Treatment

Non-insertional Achilles tendinitis can be persistent. Nonoperative treatment may take nine months to a year to be effective. However, many patients do improve and never go on to need surgery.

Calf: Stand about three feet from a wall or counter. Turn the symptomatic foot inward slightly, then step forward with the opposite foot towards the wall, and lean against the wall. Focus on keeping the back knee straight and the heel against the ground, while the front knee bends. Keep your torso in line with the back leg. You should feel the stretch high on the calf, towards the inside. Do not bounce. Hold this stretch for several minutes. In order to effectively stretch this muscle when tight, you should aim for about twenty minutes of stretching a day, though you can divide this into small increments at your convenience. Stretch both sides to prevent injury on the other side.

NON-INSERTIONAL ACHILLES TENDINITIS

Treatment

Anti-inflammatories
NSAIDs should be taken around the clock for two to three weeks for anti-inflammatory dosing. Speak to your physician if you have concerns about whether anti-inflammatories are safe for you.

Heel Cup/Lift
You may have already found that boots or shoes with a slight heel are more comfortable. This is because it takes a little tension off the tight calf muscle, and therefore of the Achilles tendon. Adding a silicone heel cup with a slight lift in your dress shoes and tennis shoes can make the activity more comfortable until your calf becomes less tight.

Ice
Only use ice if you have no numbness in your feet. If you have any neuropathy, ice application may not be safe. Wrap the ice pack with a dry washcloth to protect your skin. Ice for up to twenty minutes at a time, and be sure to wait an hour if you are going to repeat the ice application.

Physical Therapy
Physical therapy is commonly prescribed for Achilles tendinitis. The supervision and modalities that therapists are able to offer patients make it more effective than simple home stretching routines.

What Not To Do
Do not get cortisone injections into the Achilles tendon, because it will increase the risk of rupture of the tendon.

Summary of treatment

  • Calf stretches
  • Anti-inflammatories
  • Silicone heel lift
  • Ice
  • Physical Therapy
  • Surgery, only when all else fails

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