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  • Mary Carolla

Achilles Tendonitis


If you’ve ever experienced pain in your heel that has you feeling like you have a lego brick in the heel of your foot, it might be Achilles tendonitis.


Ok. I may be exaggerating slightly, but my point is - it hurts.


A lot.


Like Plantar Fasciitis, this condition can be extremely painful due to inflammation and can be difficult to treat since there isn’t a one-size-fits-all solution. This post will look at the anatomical function, causes, and treatments for Achilles tendonitis, including massage.


Anatomy of the Achilles tendon:

The Achilles tendon originates from the gastrocnemius more commonly referred to as the calf muscle and soleus, which lies directly under the gastrocnemius It inserts into the heel bone (calcaneus) and is the largest tendon in the human body. It is essential for running, jumping, and walking. Unfortunately, this makes it a common site of injury.


The primary action of the Achilles tendon is to facilitate plantarflexion of the foot, which occurs when the toes are pointed downwards. It also aids in the movement of the ankle joint, allowing for dorsiflexion (pointing the toes toward the shin bone) and inversion/eversion, movement from side to side.


Activities involving repetitive stress on the tendon, such as running, jumping, and high-impact sports like basketball, football, and soccer, are most likely to cause Achilles tendonitis. Occupations that often experience higher rates of Achilles tendonitis are ballet dancers, construction and warehouse workers, and restaurant staff. Other contributing factors include sudden increases in activity level, wearing high heels or poorly fitting shoes, and overpronation of the foot.



Tendonitis vs. Tendinosis:

Tendonitis tends to be an umbrella term to describe inflammation of the Achilles tendon, but if you’ve been dealing with symptoms for more than 6 months, the tendonitis has become a tendinosis or chronic condition. And as is true of all tendinosis, the pain can disappear, only to reappear at a seemingly random time.


Signs and Symptoms:

Symptoms of Achilles tendonitis include pain and stiffness in the lower leg or heel, particularly in the morning or after periods of rest. The affected area may also be tender to the touch and swollen due to inflammation from tiny micro tears in the tissue. In severe cases, individuals may experience a partial or complete rupture of the tendon, which requires immediate medical attention and surgical intervention. A full rupture, however, is very rare.


Treatment:

As I mentioned, finding relief from your Achilles tendonitis can be tricky. Like all tendons, the Achilles is avascular, meaning it gets little to no blood flow, which means healing tends to be slow. Symptoms can linger for weeks, months, or even years in varying degrees. Fortunately, there are many effective treatments for Achilles tendonitis, including massage therapy.


At-home treatments, including rest, ice, compression, elevation (RICE), and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, can help you manage the symptoms and pain of Achilles tendonitis.


Custom orthotics that help to correct overpronation and other structural problems in the foot and ankle can offer some relief by supporting and taking the tension off the tendon. Supportive shoes around the house, such as may also help.


The one caveat I will mention is that you don’t always want to wear shoes. Wearing shoes constantly does not allow your ankle to go through its full range of motion, thus causing a stiff ankle and possibly tearing the remodeled tissue while walking barefoot. The best thing to do is to find a good balance between shoes on and off. That balance can look different for each person. As anyone who has spent any amount of time with me knows, I wear shoes pretty much only outside or when I'm required to.


What if you need professional help? If professional treatment is required, a physical therapist or massage therapist can provide particularly effective treatment when combined with at-home OTC treatments.


A skilled massage therapist can use various techniques to target the Achilles tendon, including deep tissue massage, myofascial release, and trigger point therapy. Massage can help alleviate the pain and stiffness associated with Achilles tendonitis by increasing mobility in the calf, increasing range of motion by working on the connective tissue around the ankle, reducing inflammation, and promoting healing.


Stretching and strengthening exercises can be done with the guidance of a physical therapist to ensure you don’t cause further injury. It is also important to avoid activities aggravating the condition and gradually increase activity levels over time.


It’s important to remember if symptoms get worse or you are not seeing measurable results with other therapy options, consult a doctor or orthopedic specialist. Recovering from Achilles tendonitis can be a long, frustrating process, but with proper care and attention, a full recovery and return to normal activities are possible. If you think massage might be the right treatment for your Achilles tendonitis, reach out to me to see how I can help.


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