Back of the Achilles Heel Pain [Causes, Symptoms & Best Treatment]
Back of the Achilles Heel Pain: The Achilles tendon inserts into the back of the heel. It can lead to insertion pain and retrocalcaneal bursitis, FIX IT!
Bump on the back of my achilles tendon causes:
Achilles Tendon & Back of Heel Pain
Back of the Heel Pain Causes:
Back of the heel pain is most commonly caused by the Achilles tendon and back of the calcaneus damage.
The most common causes of back heel pain are:
- Fat pad atrophy can lead to calcaneus bone pain.
- Insertional Achilles tendinitis pain.
- Achilles tendinitis 2-6 cm above the heel bone.
- An Achilles tendon strain or rupture.
- Nerve impingement or entrapment in the heel.
- Achilles tendinosis.
- Back of the heel spur pain.
- Achilles tendon bursitis.
- Plantar fasciitis.
Achilles Tendonitis Symptoms:
- Achilles tendonitis symptoms can be a pain in the morning when you first wake up.
- Pain when trying to bend the foot up as the Achilles tendon inserts into the back of the heel.
- Worsening inflammation and tenderness while standing and walking for long periods of time.
- Improvement when wearing good shoes, good orthotics, and supportive sandals.
Types Of Achilles Heel Pain:
1)Achilles Tendonitis Heel Pain:
- The most common cause of Achilles heel pain is an overuse injury.
- This leads to inflammation of the Achilles tendon, which leads to Achilles heel soreness.
- This will appear as morning pain that gets better with 15-20 minutes of walking!
Achilles Tendonitis Heel Pain Symptoms:
- Pain in the back of the heel.
- Sore insertion of the Achilles heel.
- Swelling may occur.
- You may experience Achilles heel soreness in the morning.
- The stiffness and pain go away with walking.
- Decreased strength.
- Sluggishness in the calf muscle.
See the Achilles Heel Pain Treatment Section Below.
2)Achilles Heel Tear:
- An Achilles tear usually partial.
- A complete tear can occur. This will lead to a complete loss of calf muscle function.
- Most common in males 30-50 years old.
- Especially jumping or falling.
Achilles Heel Tear Symptoms:
- There will be a sudden sharp tearing feeling.
- This is usually in a big fall.
- Severe heel pain.
- Will not be able to stand on tippy toes.
- If you look at both Achilles’ tendons, there will be a groove if fully torn.
3)Achilles Heel Spur:
- An Achilles heel spur can usually develop.
- This usually happens after years of Achilles heel pain & inflammation.
- Chronic overuse can lead to micro-tears that fill in with blood.
- This blood can then calcify over time.
Achilles Heel Spur Symptoms:
- Achilles heel soreness.
- Usually worse in the morning, gets better with light walking.
- You can feel a palpable mass with your fingers.
- It may press against the back of the shoe and cause pain.
See the Achilles Heel Pain Treatment Section Below.
4) Achilles Heel Pain Running:
- Walking and running are the most common causes of Achilles heel pain.
- This condition is frequently due to overuse of the tendon.
- Every step you take during running strikes at 3-4x your body weight.
- During walking, this can be around 2x your body weight with each step.
- So for most of us, that is about 800 pounds of weight with each step!
- This continues for a few thousand steps.
Achilles Heel Pain Running Modifications:
- If your plantar fascia, Achilles tendon and hamstrings are tight, this needs to be corrected.
- Studies show that you need at least a certain amount of flexibility, which most non-athletes do not have!
- If you cannot dorsiflex your foot 10 degrees (or 80 degrees to the shin), you are at risk!
- This alters your running mechanics and places extra unnecessary strain on your foot and ankle.
Achilles Heel Pain Treatment:
1) Sore Achilles Heel Pain Relief!
- This stage alone can give 50-60% complete resolution of symptoms!
- It will take a couple of days or weeks to decrease the pain.
- Once the pain is gone, stretch and exercise to strengthen the Achilles!
A)Massage The Back Of The Heel & Achilles:
- Use your hands.
- Use a tennis ball.
- Use a rolling pin or any other online special item.
- Anything will work as long as it doesn’t damage the skin.
- Any blood flow or motion will decrease the pain within 15-20 minutes.
My Recommendation: Freeze a water bottle, stick it in an old t-shirt and ice your Achilles!
B)Ice The Back Of The Heel & Achilles:
- Do this 2-3x a day for 2-3 days.
- The inflammatory process needs to end for healing to being.
- Each session of 15-20 minutes will decrease the flow of inflammatory cells.
- Afterwards, the arteries will vasodilate, flushing out inflammatory cells.
- Ice has deeper penetrating power than heat.
- But heat can work as well.
My Recommendation: Use ice rather than heat.
C)Topical or Oral Anti-inflammatory Medication:
- These include Ibuprofen & Aspirin.
- This can be over the counter or prescription.
- Do not take these unless instructed to do so by your physician or podiatrist.
- Take a 1-2 week course of pills.
- This will decrease inflammation and speed up your healing time.
- Take 2-3x doses per day as instructed by podiatrist,
- This dosage builds up anti-inflammatory enzyme levels in your system.
- Taking just 1-2 pills and then stopping does nothing for inflammation!
My Recommendation: Be careful of stomach irritation!
D)Once pain is decreased, start Achilles heel stretches & exercises!
- Achilles heel exercises and stretching are needed to correct the cause of pain.
- Studies show that at least 10 degrees of ankle motion off the floor are needed to walk without stressing the Achilles tendon.
2) Achilles Heel Stretches & Exercises:
- The plantar fascia & the Achilles tendon are basically a continuation of each other.
- They both need to be stretched out to take tension off the Achilles tendon.
- Biomechanical studies show that the foot needs at least 80 degrees of dorsiflexion to the leg (10 degrees off the ground.).
- If it does not, the foot must compensate.
- This puts increased stress on the Achilles tendon.
A) Plantar Fascia Stretching Exercises:
- Most stretches of the plantar fascia stretch the calf as well.
- The calf and plantar fascia are essentially a continuation of each other.
- Pick one stretch for each muscle group.
- All stretches should be for 15-30 seconds until tightness.
- Do these 2-3x per day.
- The entire stretching session should take less than 5 minutes per day.
B) Achilles Tendon Stretching Exercises:
- Stretch your calf muscle as well as the plantar fascia.
- Most stretches work both the plantar fascia and the Achilles tendon.
- All stretches should be for 15-30 seconds until tightness, 2-3x for the calf.
- Stretching will take a long time, weeks and months!
- This will keep your pain away and make you feel more athletic than ever!
- Studies show stretching is the single most important thing to keeping the pain away.
C) Hamstring Stretching Exercises:
- It is also extremely important to stretch out your hamstring.
- All stretches should be for 15-30 seconds until tightness, 2-3x for the plantar fascia.
- Stretching this muscle out will help take tension off the Achilles tendon.
My Recommendation: I like to always stretch both legs at once. This saves those crucial minutes!
D) How Long Do I Keep Stretching:
- Pick one plantar fascia, Achilles tendon, and hamstring stretch.
- Ideally, you will stretch even more muscles in the leg as you become more knowledgeable.
- In a few weeks, you will notice how flexible you are becoming.
- It will feel less painful to walk and run.
- With more elasticity, the joints work much more naturally.
- You will be able to stand longer and run farther.
- It should even decrease your knee, hip, and lower back pain.
- You will notice results in a couple of weeks, and hopefully, continue this habit for life!
- Stretching is the secret to amazing running and walking biomechanics.
- Don’t ignore it!
3) Extra Heel Support & Shoes:
- This stage gives 80-90% success in relieving symptoms!
- Once you regain some flexibility, support is needed!
- This means good over-the-counter arch supports.
- It also means a proper pair of shoes to keep the pain away.
A) Heel Supporting Shoes:
- Get a good running shoe.
- Make sure it has a stiff base.
- Make sure it is not too flexible.
- Make sure there is enough room for your big toe and pinky toes.
- The heel counter should be rigid.
- The average running shoe should be worn less than 400 miles or so.
- This is about 3-6 months, don’t keep a shoe for years!
- I’m as frugal as it gets, but you can get a good new shoe for $35 on sale.
- Don’t risk your future mobility!
B) Fit Supporting Shoes Properly:
- Fit your shoes in the evening.
- Your feet are the most swollen at night.
- Use a Brannock device to measure your size properly.
- Measure your foot length.
- Measure your arch length.
- Measure your foot width length.
C) Achilles Heel Pain Orthotic:
- Get a good rigid over-the-counter foot orthotic.
- There are many crummy brands out there.
- Get a rigid pair that supports the arch.
- This is extremely important.
- Try ordering Powersteps online. They are about 20-30$.
D) Treat Your Plantar Fasciitis!
- Does the bottom of your arch hurt as well?
- Think Plantar Fasciitis!
Back of the heel pain treatment:
Best Back of Heel Pain Treatment:
- There are usually two phases to treating back of the heel pain.
- The two phases of treatment include controlling the acute inflammation and correcting the biomechanics, which led to the problem in the first place.
- If the tendons and ligaments are inflamed, they are almost frozen in place and cannot function properly.
- Once the inflammation is decreased, we need to correct the biomechanical causes to ensure that the Achilles tendon can never become overworked and inflamed again!
- This doesn’t matter whether it’s The back of the heel spur, fat pad atrophy, insertional Achilles tendinitis, Achilles tendinitis, or even Achilles tendinosis.
- If you do have an Achilles tendon rupture or tear, seeing podiatrist care immediately.
Achilles Tendon Natural Treatment:
Massage & Ice Products:
- Ice is an excellent option that can be safe for almost everyone.
- There is some debate about whether icing is worth doing, but this can help limit the need for medications and keep your options open for chronic pain.
- This works great for your arch, less for the ball of the foot.
- Manual massage on the Achilles tendon & calf muscle is a natural treatment that can also be considered physical therapy for your back of the heel pain.
- This works well for calf muscle pain and Achilles tendon pain.
- The more muscle and ligament tissue there is, the better ice will work there.
Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- This can be very effective for pain relief, but this can decrease inflammation in the calf muscle and Achilles tendon.
- These can work great for loosening your muscles.
- This allows less tightness and pressure onto the plantar fascia and heel.
- This is very effective for the arch, the gastrocnemius, calf muscle, and the hamstring and thigh muscles.
- This also works very well for the gluteus muscles if you are having butt cheek or hip pain.
- The massage stick can break up lumps in your Achilles tendon and heel pain.
Remove the Achilles tendon tightness.
- The key is to prevent future pain stress and trauma to the Achilles tendon muscle.
- This means keeping you active while keeping stress off of your Achilles tendon. This will prevent future re-injury and the development of plantar fasciitis.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- The best way to ensure that your plantar fascia, foot, and ankle ligaments are not overworked is to support them.
- The best way to support them is to use great orthotics and great shoes.
- Some people may also need to rely on supportive ankle braces and other supportive modalities.
Best Shoes for Back of Heel Pain:
- Getting a great supportive pair of Achilles tendonitis shoes will ensure that there is pressure removed from the heel and plantar fascia region.
- This is especially important if you have plantar fasciitis, heel spur pain, or Achilles tendonitis as well.
- Consider Achilles tendonitis shoes combined with a good supportive orthotic for best pain relief!
- The following link will show you what our favorites are.
Best Achilles Tendonitis Insoles:
- These are our recommended orthotics for Achilles tendonitis.
- Custom orthotics can work very well, but they should not be the first line of treatment due to the cost.
- There are different types of different shoes.
- Women’s shoes usually need a less bulky orthotic but allow for less correction.
- A full-length orthotic requires a running shoe, boot, or comfortable walking/dress shoe.
- We recommend doing everything you can to get a good supportive shoe that can fit a full-length orthotic.
- A further home remedy tip for Achilles tendonitis pain is cutting out a hole where the nodule uses scissors or a knife. Be careful and start with a very low-cost orthotic.
Best Full Length Achilles tendonitis Orthotics:
- These will only work in wider shoes or a good supportive running shoe.
- This will not work in sandals, flats, or most women’s dress shoes.
Best Dress Shoe Achilles tendonitisOrthotics:
- These are a great choice for dress orthotics.
Best 3/4 Length Achilles tendonitis Orthotics:
- These are great options for women’s dress shoes and thinner shoes.
- These are not the most supportive pair of orthotics.
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Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- This will take pressure off of the ball of your foot.
- This form of the back of the heel pain physical therapy breaks up the scar tissue.
- We personally prefer this method of stretching.
Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This is an excellent Achilles tendonitis physical therapy that you can do at home.
- This will also help take pressure off of the ball of your foot.
- This works great for plantar fasciitis.
- The static night splint can use it while watching TV or at night time.
Best Heel Compression Brace:
- A good compression brace can stabilize your foot from turning outward.
- This prevents your foot from pronation.
- The pronated foot will turn your foot outward, in your foot will rub on the outside of the shoe.
- This has solved their pain for many of her patients and is very comfortable to wear inside your shoe.
- This solves both pain and outward pronation for a relatively low cost.
Best Heel Stability Brace:
- The stability brace goes a little bit further than the compression brace to stop your foot from turning out.
- This takes the pressure off of your heel and plantar fascia.
- At the same time, this is a little bit bulkier and does not affect every shoe.
- We find people are a little bit happier trying the compression brace before the stability brace.
Severe Achilles tendonitis Pain:
- If you think you might have a broken heel, a calcaneal stress fracture, or something of similar severity, these products might help!
- Always remember to see a foot and ankle specialist like a podiatrist if you have plantar fasciitis or more severe pain!
Plantar Fascia Tear, Broken Heel Bone, Achilles Tendon Tear:
- If you have a traumatic injury such as a torn plantar fascia ligament, calcaneus stress fracture, heel fracture, or insertional Achilles tendon injury: consider protecting your foot!
- The best way to do this is, of course, to see your podiatrist and get evaluated with an x-ray, ultrasound, and potentially even an MRI or CT scan.
- If you cannot do so, it may benefit you to be in a cast, fractured boot, or even keep the weight off of it with a rolling knee scooter or other protective devices.
- We as podiatrists frequently take patients off work for very long periods of time when they suffer a traumatic injury. Unfortunately, there is no other way around us in labor jobs.
- If you have a sit-down job, there are ways to get people back to work quicker, but this can be not easy otherwise.
Heel Injury Boot Treatment:
- There are pros and cons to using a boot to treat your heel injury. The Pros are that your injured heel will hopefully have a chance to heal gradually! If you are immobilized too long, the cons are that you will gradually become stiff and overworked to your other leg.
- Our favorite fracture boots and their supplies:
Offloading and Scooter treatment:
- These are favorite knee scooters and walking devices.
- If your Achilles tendonitis pain is severe, offloading can be very effective until the pain calms down.