Chronic Achilles Tendinitis Rehabilitation

Chronic Achilles Tendinitis Rehabilitation

Nonsurgical Treatment

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?


Home Treatment:

-Rest- 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.

-Ice – Put the ice in the area that is most painful in the tendon and
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.

-Heel Lifts- Getting a gel heel lift with decrease the stretch on the
achilles tendon and offload it while you are walking around.

-Non-constrictive shoes- 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.

-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.

-Oral NSAIDs- 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
healing time. Ibuprofen is a good option.
-Physical Therapy – There is a great deal of scientific evidence showing
that this will greatly improve healing time.

-Weight Loss- The lower the weight, the lower the stress on your achilles
tendon- for ever pound lost, the effect is exponentially magnified in a
decrease of strain in your achilles tendon.

-Orthotics- Control your overpronation with a rigid insert that can be
purchased for approximately $25, this will prevent “twisting” of your
Achilles tendon.

-Comfortable Footwear- Get a good running shoe that does not irritate the
back of your heel and that prevents overpronation.

-Stretching- Stretch your calf as against the floor or the wall as demonstrated in the videos.

-Muscle Strengthening- Eccentric Achilles tendon exercises should be incorporated to strengthen the grastrocnemius muscle.

-The especially quickly on-setting cases especially should be treated with
immobilization immediately.