Achilles Tendinitis Treatment
What is Achilles Tendinitis and Tendinopathy?
When looking for Achilles tendinitis treatment, it is first important to understand the condition. Achilles tendinitis is characterized by pain, and sometimes swelling along the Achilles tendon. Achilles tendinosis is pain that has become chronic (lasting 3+ months). At this stage of the injury, the tendon begins to show degenerative changes. Achilles tendinopathy is more of an umbrella term for pain and dysfunction at the Achilles tendon. Achilles tendinopathy is a product of applying load to the tendon which exceeds the ability of the tendon to withstand load.
For example, a completely sedentary individual decides they want to start walking daily. They begin walking 5 miles per day up steep hills. After 3 weeks, they develop Achilles tendinitis in both lower legs. Why? The tendons were not in good condition with minimal activity demands, and then were put in a position of high strain (5 miles walks). Couple that with very minimal recovery between sessions (performing every day) and Achilles tendinitis may develop. If that same individual began their exercise program walking every other day, on flat ground starting with 10 minutes and slowly increasing the time of the walks, they would have likely have much more success in properly introducing strain to the tendons to avoid injury!
Treatment Methods
Achilles tendinitis treatment generally consists of controlling the pain. Activity modification, NSAIDS, ice/heat, various manual therapy, and stretching to the calf muscles help with this aspect. In the video above, we discuss examination procedures for the Achilles and lower leg. We also show treatment options such as Active Release Technique for Achilles tendinitis, and Graston Technique for Achilles tendinitis. Active Release Technique involves identifying tight portions of the muscles that are causing excessive tension on the Achilles tendon. Once identified, the practitioner shortens the muscle, applies firm pressure and has the patient actively lengthen the muscle. This helps loosen the muscle, break down adhesions in the muscle fibers, and promotes blood flow for healing.
Graston technique for achilles tendinopathy involves using metal tools to rub along the Achilles tendon. This promotes blood flow to the the tendon which helps promote healing to the injured tendon. The manual treatments are designed to help decrease pain and allow the patient to strengthen the tendon successfully. For long term resolution of achilles tendinopathy, loading exercises are key.
Shockwave for Achilles Tendinitis
A new treatment modality has been shown to be effective at helping resolve chronic Achilles tendinopathy. Shockwave therapy utilizes high energy sounds waves which penetrate deep into the tissues. This results in improvement in blood flow, break down of scar tissue, and improve the healing response to the injured area. Read more about shockwave therapy here.
Exercises for Tendinopathy
The most recent literature in the past several years shows that Achilles tendinitis treatment must include loading exercises to the Achilles tendon. Various eccentric, isometric, concentric loading exercises have been tested and shown to help decrease symptoms while strengthening the tendon/muscle complex. When Achilles tendonitis exercises are performed, it is ok to work through some pain. As the function of the muscles and tendons improve, the pain will begin to dissipate and not return. Achilles exercises take patience, and consistency but will help significantly with Achilles tendinitis symptoms. Ultimately, strengthening, and proper return to play will help avoid nagging Achilles tendinitis symptoms. Check out our achilles tendinitis exercise video for examples of progressions we use in the office.
