Achilles care


The Achilles tendon attaches the lower leg muscles to the back of the heel bone. It is the largest tendon in the human body and can withstand forces of 1,000 pounds or more. It also is the most frequently ruptured tendon, usually as a result of a sports injury. Both professional and weekend athletes may suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.


Events that can cause Achilles tendonitis may include:

  • Hill running or stair climbing.
  • Overuse, stemming from the natural lack of flexibility in the calf muscles.
  • Rapidly increasing mileage or speed when walking, jogging, or running.
  • Starting up too quickly after a layoff in exercise or sports activity, without adequately stretching and warming up the foot.
  • Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort, such as in a sprint.
  • Improper footwear and/or a tendency toward going too flatfooted (overpronation).
  • A difference in the length of your legs.
  • Having to go up and down stairs, or ladders, more than usual.

Achilles tendonitis often begins with mild pain after exercise or running that gradually worsens. Other symptoms include:

  • Recurring localized pain, sometimes severe, along the tendon during or a few hours after running. The pain is often referred to as "burning".
  • Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone.
  • Sluggishness in your leg.
  • Mild or severe swelling.
  • Stiffness that generally diminishes as the tendon warms up with use.

Treatment normally includes:

  • A brace specifically designed to restrict motion of the tendon and to provide a massaging action.
  • Taking nonsteroidal anti-inflammatory medication for a period of time. Note: Please consult your physician before taking any medication.
  • Use of a topical anti-inflammatory, such as Aspercreme (OTC) or one of our stronger creams such as BioFreeze, CryoDerm or ThermaDerm. We also have homeopathic creams, such as Traumeel and Heel, which work very well for most people.
  • Sometimes a series of up to four cortisone injections is considered - after discussion with you, of course.
  • Physical therapy is a mainstay of out treatment regimen. We can usually get 85% relief for people, without the need for injections. This can be done in our office or in an outside facility, depending upon your insurance company's rules.
  • Arch supports for both cushioning and support. We have a variety of OTC inserts, which tend to work well for many people.
  • If over the counter arch supports give some relief, but not enough, we might consider custom-made Orthotics , which are corrective shoe inserts designed to help support the muscle and relieve stress on the tendon.
  • Rest and switching to exercises that do not stress the tendon (such as swimming).
  • Stretching and exercises to strengthen the weak muscle group in front of the leg and in the calf.
  • If none of these give enough relief, we would next consider PRP therapy - using your own platelets to speed the healing process. It's as close to using stemcells as you can get.

In extreme cases, surgery is performed to relieve the tension on the heel bone. This is done in-office, under local anesthesia, and requires an incision that is less than 1/4" long. We resolve at least 97% of cases without the need for surgery.

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