Achilles Tendonitis

What is it?

The Achilles tendon is the largest tendon in the body, and is found at the back of the heel. Achilles tendonitis is inflammation of the Achilles tendon, and is one of the most common injuries that occur in the legs. It often occurs in sporty people, especially people who do a lot of running and jumping activities, however, it can also occur in non-sporty people. It can be very painful, and can be associated with swelling.

What causes it?

There are several factors that can contribute to Achilles tendonitis:

Overuse following injury:This is the most common form where the muscle/tendon is over used following an initial injury.
Poor function or structure:This is where a change in the relationship between bone and tendon can be caused an incorrect walking pattern or function, or where an external factor such as incorrect footwear, can change the way the Achilles tendon functions. This damages the tendon sheath, resulting in painful inflammation of the area.
A sudden increase in training:Rather than a gradual increase in exercise, a rapid change in the use of the muscles can cause problems.
Poor footwear:Excessive heel cushioning and air-filled shoes can, over a period of time, lose their stability. Continued use of this footwear can cause the heel to sink into the shoe. This further stretches the Achilles tendon during times when the leg and body are moving forward over the foot.

What would a typical treatment plan involve?

Achilles tendonitis responds well to conservative treatment, if treated early. This may involve:

  • R.I.C.E. (Resting, icing, compressing, and elevating the area)
  • If required our Podiatrists can write out a bulk billed referral for Xrays and Ultrasound for further investigation and imaging.
  • Specific exercises or stretches which can be prescribed by your Podiatrist
  • Heel raises: these decrease the strain and load on the Achilles tendon. They should only be used for a short period of time
  • Correction of abnormal function in the feet – Orthotics may be prescribed by your podiatrist. They are designed to allow the foot to function around position which reduces abnormal forces being applied to the Achilles tendon. This allows the Achilles tendon to heal, and prevents recurrence of the injury.
  • Medical shockwave therapy – this treatment modality is very effective in conjunction with orthotic therapy, particularly in long term cases of Achilles tendinitis. Shockwave generally offers immediate relief and accelerates healing to the immediate injury.

You should call your podiatrist if your pain is not healing, if it worsens, or if you have any concerns.