How to Treat & Prevent Achilles Tendinitis

What exactly is Achilles Tendinitis?

Achilles tendinitis is an overuse injury of the tendon that connects the back of your leg to your heel.

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.

Achilles tendinitis may be more likely to occur if:

• You suddenly increase the amount or intensity of an activity
• Your calf muscles are very tight (not stretched out)
• You run on hard surfaces such as concrete or asphalt
• You run too often (too much volume)
• You jump a lot (such as when playing basketball)
• You do not have shoes with proper support
• You run uphill a lot
• You wear high heels a lot (calf muscles shorten)

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How do I know if I have Achilles tendinitis?

Typically a doctor will take X-Rays or MRI to rule out other serious pathology and diagnose you with tendinitis or tendinosis.

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What are the standard or traditional Physical Therapy treatments?

Standard treatment includes rest, ice, anti-inflammatory medication, stretching, strengthening, and eccentric exercise. A doctor may also recommend a cortisone injection.

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How would a Manual Physical Therapists treat Achilles Tendinitis?

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).

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Are there any precautions I should take when dealing with Achilles Tendinitis?

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.

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Is there anything I can do to prevent Achilles Tendinitis from happening in the future?

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.

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FMT is the key to faster healing. It is why many clients tell us they received the same benefit after one FMT session as five traditional physical therapy sessions they had tried before. FMT is not traditional physical therapy. Learn more...

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