Description

The Achilles tendon is the large tendon that runs down the back of the lower leg and connects the calf muscle to the heel bone (calcaneus).  Achilles Tendonitis (sometimes referred to as Achilles tendinopathy) is an inflammation of the tendon most commonly due to poor foot mechanics (such as over pronation), overuse (such as increased activity or repetitive activity) or excessive tightness in the tendon or muscles.  It is usually the result of a sudden injury, strain or an ankle equinus deformity which is when the achilles tendon is shorter than needed to allow adequate dorsiflexion during the gait cycle. Achilles tendonitis can be seen in people of all foot types, yet commonly affects runners and other athletes.

Symptoms

Pain (including aching, swelling, soreness, tenderness and tightness) either constant or periodic at the back of the heel (Achilles insertion point) or 2-6cm above the insertion point. Pain can be present after a lack of activity, such as when taking first steps in the morning or after a period of rest, although typically the pain will escalate with increased activity.  If left untreated, Achillies Tendonitis can potentially progress to Achilles Tendinosis, which is a chronic problem that develops gradually and can last for a long period of time.

Pedorthic Management

• Custom made orthotics – Help to provide proper support and alignment to the foot, controlling conditions such as over pronation, which help to reduce stress on the Achilles tendon and calf muscles.
• Temporary heel lifts – Raise the heel to take strain off the tendon
• Orthopedic footwear – Properly fitted, strong, structured footwear and stable with good shock absorption an adequate heel height to reduce strain on the tendon.

Other Treatments/ Modalities

• Rest/immobilization and ice
• Stretching exercises
• Anti inflammation medication
• Injections – ie cortisone
• In severe cases, treatment can include surgery
• Ultrasound, laser