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!
Back of the heel pain is most commonly caused by Achilles tendon and back of the calcaneus damage.
The most common causes of back heel pain are:
- Fat pad atrophy that 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.
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, this 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 calf muscle.
See the Achilles Heel Pain Treatment Section Below.
2)Achilles Heel Tear:
- An Achilles tear is 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.
- The 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.
- Ever 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 through 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 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 on-line special item.
- Anything will work as long as it doesn’t damage at 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 the 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 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 you 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 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.
- May 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 hurts 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 bio-mechanical causes to ensure that the Achilles tendon can never become over worked 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 a podiatrist care immediately.
Achilles Tendon Natural Treatment:
Massage & Ice Products:
- Ice is the an excellent option that can be safe for almost everyone.
- There is some debate whether icing is worth doing, but for chronic pain this can help limit the need for medications and keep your options open.
- 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 or calf muscle and for 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 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 make sure 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 a first line of treatment due to the cost.
- There are different types for 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 to cut out a hole where the nodule is using 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.
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 is a for of back of the heel pain physical therapy that 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 a very good 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.
- It can be used 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 pronated.
- Pronated foot will turn your foot outward in your foot will rub on the outside of the shoe.
- For many of her patients this has solved their pain and is very comfortable to wear inside your shoe.
- This solves both pain and outward pronation for a relatively low cost.
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Best Heel Stability Brace:
- Stability brace goes little bit further than the compression brace to stop your foot from turning out.
- This takes 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 little bit happier trying the compression brace before the stability brace.
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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 are having 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 are unable to 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 period 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 very difficult otherwise.
Heel Injury Boot Treatment:
- There are pros and cons to using a boot to treat your heel injury. If you are immobilized too long the cons are that you will gradually become stiff and overworked to your other leg. The Pros are that you injured heel will hopefully have a chance to gradually heal!
- 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 it can be very effective until the pain calms down.