Achilles tendonitis is a condition in which the achilles tendon becomes injured and inflamed where it inserts into the heel bone or higher up in the leg.
Achilles tendonitis is characterized by pain in the heel or tendon when first arising from bed in the morning or from a seated position. The pain occurs because the injured tendon has tightened during rest and the sudden weight-bearing causes excessive pulling. The pain generally will ease up after a few minutes of walking.
There can be various causes of this inflammation, but it is common to see achilles tendonitis in people that have a foot type that flattens or pronates. Excessive flattening can cause the heel bone to be unstable forcing the achilles tendon to work harder to stabilize the bone. A naturally tight achilles tendon (equinus) can also contribute to this inflammation. With time, small tears of the tendon can occur where the tendon inserts and a heel spur can form as the body tries to repair these tears. An inflamed bursa or bursitis can also form around the achilles tendon insertion with chronic inflammation.
What we can do to help you solve this pain
If you have pain in the back of your heel, we recommend that we see you as a patient. If left untreated, the inflammation of the tendon can become chronic which can contribute to abnormal thickening of the tendon and enlargement of the spurring on the back of the heel.
Initially, we will perform a complete history and physical examination of your feet to determine the exact cause of your achilles tendonitis. We will perform a comprehensive biomechanical examination to determine what role this plays in your problem. We will take digital x-rays to assess the heel bone and to look for spurring and thickening of the tendon. We will help to educate you on proper shoe gear and discuss activities to avoid to help treat your pain. We will show you the proper stretching exercises to do for the tightness in your tendon.
Prescription anti-inflammatory medications may be needed to help reduce the inflammation. We also have good results with topical anti-inflammatory creams. A cortisone injection may sometimes be used to help. If you have pain when first arising in the morning, we often will recommend a night splint to wear to bed to help stretch the tendon gently overnight. We have these night splints available here.
Achilles tendonitis often responds well to proper arch supports or prescription orthotics. If your achilles tendonitis is mild, we may be able to use a pre-made arch support to control the abnormal flattening of your arch. We carry arch supports in our office that are typically much better than what you will find in the store. Some cases of achilles tendonitis are more severe and may require the use of prescription orthotics. Orthotics are a custom-made arch support that is made from a plaster impression or digital scan of your foot and arch. Unlike pre-made arch supports, however, an orthotic completely controls abnormal pronation or flattening of the arch. Read more about custom orthotics.
If conservative treatment is not effective, surgery may be needed if there is chronic bursitis or excessive spurring formation on the back of the heel.
The doctors at Council Bluffs Foot & Ankle Care are experts in the treatment of this painful condition. If you have achilles tendonitis, call us to make an appointment. We want to help you resolve this pain and start enjoying life again.