The Achilles tendon is the thick, strong tendon at the back of the ankle connecting the gastrocnemius muscle (superficial muscle) and soleus muscle (deep muscle) to the heel bone (calcaneus).
You can have insertional tendinitis right at the heel bone (due to low blood supply) vs. non-insertional that is higher in the muscle belly or at muscle-tendon junction. You can also have acute tendinitis which is more related to inflammation vs. chronic tendinosis which is more related to micro-tears and poor quality of the tissue.
Symptoms for Achilles tendinitis are generally comprised of achiness and pain at the back of the lower leg and ankle.
Typically a doctor will take X-Rays or MRI to rule out other serious pathology and diagnose you with tendinitis or tendinosis.
Standard treatment includes rest, ice, anti-inflammatory medication, stretching, strengthening, and eccentric exercise. A doctor may also recommend a cortisone injection.
A Manual Physical Therapy would work on the joint mobility of the ankle, foot, and knee as necessary and improve soft tissue mobility of the tendon and muscles of the lower leg. In addition, a Manual based approach would include working to improve strength and coordination through specific manual techniques. Typically we (therapists) find restricted ankle joint folding, poor length and play (side to side motion) of the Achilles, gastrocnemius, and soleus, and weakness of the other muscles that propel you forward in running (glutes, hamstrings, core).
There should be no precautions in general for just tendonitis. Your therapist should give you detailed exercise or running progressions. On a side note, taking statins (cholesterol medications) and some antibiotics (Cipro, Levaquin) have been shown to potentially weaken tendons, so proceed with caution with intense activity when taking statins or antibiotics.
Wearing proper footwear, using proper exercise volume and intensity, keeping a good range of motion of the ankle and calf muscles, good strength and balance, as well as good running mechanics all, can play a part in preventing this injury from recurring in the future.
Founded in 2004, Elite Health Services, with locations in Old Greenwich, CT, is a world-class provider of certified Functional Manual Therapy™, personal training, pilates and running services. Elite Health Services has already helped thousands of your colleagues, friends and neighbors throughout Lower Fairfield County.
Contact us today to learn more about how we can help you, too.
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