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Ask your Physical Therapist: What is Achilles Tendonitis and How Do I Get Rid of It?

First of all let me clarify what the Achilles tendon is.  The Achilles tendon is a tissue that connects your calf muscle to the back of your heel bone.  Tendons connect muscle to bone and Ligaments connect bone to other bones.   

Achilles tendonitis is an irritation or inflammation of the tendon as it connects to the back of your heel.  This condition can be very painful and usually makes you walk with a limp as it worsens.  Normally the pain from Achilles tendonitis is worse after you have been sitting for a while  and go to get up and walk for the first few steps and it is equally as bad for the first few steps out of bed in the morning.  Typically, the pain lessens a bit the more steps you take, but as the condition worsens, the pain also is present the more you walk and the more active you are in addition to pain in the am and after sitting.

Achilles tendonitis can occur for many different reasons such as: flat feet or high arches that cause the heel to drop in or roll out excessively placing excessive tension on the Achilles where it attaches, trauma to the tendon like getting kicked or hit on the Achilles during sports, having one leg that is longer than the other, doing too much walking, running or weight bearing activity without gradually progressing into that activity. 

Many times, folks with Achilles tendonitis have tight and or weak calf muscles, which place undue stress on the tendon.  The Achilles tendon’s response to this is inflammation, which acts as a protective measure to ensure that the pain stops you from damaging the tissue further.

Treatment of Achilles tendonitis consists of a Physical Therapy evaluation in order to determine the root cause of the problem and to identify which muscles are tight and which are weak that may have contributed to the issue.   The Physical Therapist will instruct you in how to modify your current activities to allow the tendon to “rest and heal” and they will perform anti-inflammatory treatments, taping techniques, custom foot orthotics and proper shoes for your specific foot type.   In addition, your Physical Therapist may want to perform a video gait analysis while you walk (or run if you are a runner) to determine if your walking pattern is a contributing factor to the Achilles tendon irritation.

It is imperative that you address this issue when it arises as if it is left untreated it could lead to injury to the hips, knees or low back due to compensatory patterns from limping.  In addition, if one tries to “work through” the pain they are placing themselves at risk for a possible rupture of the Achilles tendon.

Please email me if you have any questions regarding Achilles Tendonitis or any other orthopedic ailment and I would be happy to answer your questions:

Steve Miller PT, C.Ped is the owner of Cardin and Miller Physical Therapy in Carlisle & Mechanicsburg.