A condition characterized by the presence of pain behind the heel originating in the Achilles tendon, the most important tendon in the calf region. The terms tendinitis, tendinosis and tendinopathy refer to the stage and severity of the condition. The Achilles tendon is the most commonly injured tendon among runners.
How does it work?
The Achilles tendon is the cord-like tissue located behind the ankle that connects the calf to the heel. With its fibers forming a spiral structure, it is one of the strongest tendons in the human body and it plays a critical role in the movement. We have the Achilles tendon to thank for being able to stand upright seemingly effortlessly. When we run, the Achilles tendon springs into action to propel us forward with ease. It also plays a pivotal role in allowing us to jump. Finally, it greatly helps absorb the impact sustained by the foot. But this “supertendon” also has its weak points. The blood supply to the Achilles tendon is poor. As a result, it is more prone to injury and heals relatively slowly. When the Achilles tendon suffers repeated and excessive force, microtears can form, leading to inflammation.
Symptoms of Achilles Tendinitis
Pain behind the heel or ankle pain usually occurs right after rest or when you take your first steps in the morning and worsens after physical activity, when walking up or downstairs or inclined surfaces, and when running on uneven terrain. The Achilles tendon may thicken or form a bump and there may be visible redness and swelling.
Diagnostic of Achilles Tendinitis
X-rays must be conducted on the Achilles tendon to check for calcium deposits and bone spurs. X-rays also make it possible to rule out other causes of heel pain and to assess the alignment of the bones in the foot.
Ultrasound is an excellent imaging technique and diagnostic tool. It allows the podiatrist to observe the entire tendon, measure its thickness, evaluate the severity of the injury, assess the fiber structure and check for the presence of tears. It also allows us to rule out other conditions affecting the structures surrounding the Achilles tendon.
To identify whether poor foot alignment or posture may be at fault, a thorough biomechanical exam is essential. This comprehensive evaluation of foot function, gait and posture provides invaluable information. It also includes an analysis of plantar pressure during gait using pressure sensors connected to cameras.
Treatment for Achilles Tendinitis?
Once the problem has been diagnosed and its potential causes identified, your podiatrist will be able to recommend a personalized treatment plan for your condition.
Plantar orthotics help reduce the tension on the Achilles tendon by addressing mechanical problems in the feet. They allow the Achilles tendon to function properly and avoid twisting caused by gait disturbances.
Radial shockwave therapy:
Used in chronic cases where patients fail to respond to treatment, this therapy uses the body’s natural capacities to restart the healing cycle, a bit like a time machine. This therapy is successful in 80-90% of chronic cases.
Painkillers, muscle relaxants and/or anti-inflammatory drugs may be prescribed.
Our specialized physiotherapists in collaboration with our podiatrist can offer to help rehabilitate patients physically or neurologically.
- Manipulative therapy
- Taping, splints and walking boots
- Stretching, strengthening and balance exercises