The Achilles tendon is the largest tendon in the body and encounters large forces during certain activities, often up to several times our body weight. Achilles tendonitis is typically an overuse type of problem, exacerbated by running or walking on hills, or activities like step aerobics. One of the worst things you can do with Achilles tendonitis is to ignore the pain and run or exercise through it. Training modification is usually necessary; the earlier you recognize and identify the problem, the easier and shorter the recovery time will be. Stretching (of the posterior muscle groups; Achilles, hamstrings), icing, avoiding hills, wearing a temporary heel lift, orthotics, shoe modifications, medication, and physical therapy are all used to address Achilles tendonitis. Ignoring Achilles tendonitis can lead to chronic degeneration and tears in the tendon, which often do not heal well. Early treatment and prevention is very important.
Younger individuals (i.e. 10 to 14 years old) who are very active with sports, such as gymnastics and basketball, will often feel pain at the back of the heel. In most cases, this is due to irritation and inflammation of the growth plate at the back of the calcaneus (heel bone). This is usually treated with a few weeks of immobilization, rest from activities, and gentle stretching of the Achilles. Following resolution of the pain, it’s important to consider physical therapy to stretch out the Achilles; we also consider orthotics to address faulty foot mechanics and limit rotation of the heel bone.
Many people develop or have a bony prominence at the back of the heel bone, which can be a “Haglund’s deformity” or a “retrocalcaneal exostosis.” This prominent projection of bone at the back of the heel can be a source of irritation from shoes, but also tends to disrupt the normal attachment of the Achilles to the calcaneus bone. Tendonitis will often occur, which can be treated with anti-inflammatory medications, heel lifts, orthotics, heel pads, etc. In some cases, due to the abnormal prominence of bone, surgery is indicated to remodel the back of the heel and repair the damaged portions of the Achilles tendon. This can often be done without releasing the Achilles tendon, or with a partial release of the tendon, which shortens the overall recovery time.
Other Achilles tendon problems include rupture (partial or complete), bursitis, and congenital shortening of the Achilles. Those born with a short Achilles tendon are typically “toe-walkers.”
If you are dealing with any problem affecting the Achilles tendon, we encourage you to get it checked out. It’s not normal to hurt, and continuing to exercise on an injured area can magnify the injury. Remember, injury prevention and earlier treatment usually leads to better short- and long-term successful outcomes.
For more information, please call 661-260-1180.