Often time achilles tendonitis is from repeated or intense strain on the Achilles tendon, though sometimes the cause is unclear. The Achilles tendon is the band of connective tissue that joins the calf muscles to the heel bone. This tendon is used while walking, running, jumping, climbing or standing on tip toes. Developing this condition can be influenced by intrinsic and extrinsic factors.

Intrinsic factors: These include age, sex, foot type, muscle weakness/ imbalance etc

Extrinsic factors: Increased activity/mileage rapidly, improper footwear, insufficient warming up/cool down or stretching, training surfaces, and direct trauma, etc

Symptoms may begin as a mild ache or stiffness in the back of the leg or above the heel after activity. Overtime this pain may increase and occur during/after running, jumping, stair climbing or sprinting.

Conservative Treatment

• “RICE” Rest, Ice, Compression, Elevation

• Reduction of activity levels.

• Oral medications

• Shoe gear changes/Orthotic/Supportive devices

• Immobilization

• Physical therapy

  • Stretching exercises

  • Tendon strengthening

  • Manual therapy, Graston, Dry needling

• Pain laser, extracorporeal shock wave therapy (ESWT)

• Injection Therapy biologic/amniotic, PRP,

Surgical therapy is optional for 10 to 30% of patients who fail conservative therapy.

• Open/Endoscopic Debridement

• Topaz or Tenax

• Resection of the superior calcaneus (Haglund deformity) and bursa

• Detachment and reattachment of the Achilles tendon