Chronic Achilles Tendinitis Rehabilitation [Causes & Best Home Treatment]
90% of the time people find success with chronic Achilles tendinitis rehabilitation. We go over causes, symptoms & best treatment! Get better FAST!
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.
- Be prepared to treat your Achilles tendinitis for a few months, because the general rule is that it will take just as long to get rid of it as you have had it.
- The goal in most cases is to decrease the pain gradually well before the 3 month point, but in some cases it can take up to 6 months of conservative treatment before the Achilles tendinitis is
Factors that put you at risk:
- Put stress on your body that it is not used to: This is the weekend warrior or someone who exercises really hard after sitting on the couch for the last 4 months.
- Having very tight calf muscles: If you have trouble getting anywhere near your toes this may be you!
- Calcification of the the Achilles tendon at the insertion: Can you feel some unusually bone formation at the back of your heel?
- No athlete wants to hear it, but the bottom line is that any high impact activity will prolong the healing time.
- Try to find an activity that puts less strain on the Achilles tendon like swimming or biking for at least a week or two until the inflammation calms down.
- Put the ice in the area that is most painful in the tendon.
- This should be done for approximately 15-20 minutes until numbness begins to set in.
- This is less for the pain and more for a decrease in inflammation which will lead to increased healing time.
Topical anti-inflammatory or analgesics:
- There are anti-inflammatory creams that can be prescribed by your podiatrist that can decrease the inflammation and speed up your healing time.
- Consider menthol based creams as an alternative:
- Getting a gel heel lift with decrease the stretch on the achilles tendon and offload it while you are walking around.
- If your Achilles tendinitis is at the insertion into the heel bone, try to find a shoe that does not rub against the back of the heel.
- Watch this shoe fitting guide to find the right shoes online.
- This can be over the counter, but the goal is to take a two week course to attempt to decrease the inflammation and speed up your
- Ibuprofen is a good option.
- There is a great deal of scientific evidence showing that this will greatly improve healing time.
- This a great option for your rehabilitation.
- Consider a massage roller to take pressure off your hamstrings and calf muscles.
- This will reduce strain on your Achilles tendon.
- The lower the weight, the lower the stress on your achilles tendon.
- For every pound lost, the effect is exponentially magnified in a decrease of strain in your achilles tendon.
- Control your overpronation with a rigid insert that can be purchased for approximately $25.
- This will prevent “twisting” of your Achilles tendon.
Heavy duty orthotics:
- These are our favorite options for heavy duty orthotics.
- If you can fit these in your shoes, test these ones out!
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.
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.
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.