Human Performance and Rehabilitation Centers, Inc.

Treating Achilles Tendonitis

Overview of Achilles tendonitis

Achilles tendonitis is a condition in which the Achilles tendon becomes painful or inflamed because of overuse. It’s often experienced by runners who make an abrupt change in their routine, such as an increase in mileage, hills or speed work without building up adequately. Weekend athletes who are sedentary during the week can also experience the condition. It’s easy to assume that Achilles tendonitis will improve on its own, but that’s usually not the case. Untreated, it almost always gets worse.

How to recognize Achilles tendonitis

Achilles tendonitis comes on slowly. Overuse causes the tendon to become tight and inflamed. Pain and swelling can occur anywhere along the Achilles tendon, which spans from the heel bone to the calf. When the condition first appears, the patient might notice some discomfort above the heel when running, walking, getting out of bed or standing for long periods. The pain and stiffness will usually worsen over time.

How physical therapy can help

Reducing inflammation in the Achilles tendon is the main goal of therapy. Depending on the patient’s level of mobility, treatment can include modalities like therapeutic ultrasound, dry needling and Astym. These modalities reduce inflammation and decrease the chances of the tendonitis from returning.

  • Therapeutic ultrasound is a highly effective treatment for Achilles tendonitis. It is used in conjunction with an anti-inflammatory gel applied to the surface of the skin. The ultrasonic waves help the gel to penetrate the tissue faster and bring relief to the inflamed area.
  • Dry needling is a form of manual therapy in which small needles are inserted into “knots” or trigger points. In Achilles tendonitis patients, it is used to address the referred pain that a patient can experience in the calf muscles. Dry needles are applied in a relatively painless manner and coax the muscle to release tension and “reset.”
  • Astym is a soft tissue therapy in which a clinician performs certain protocols of manual therapy using a small hard plastic instrument. This is an effective strategy for breaking down scar tissue and stimulating the growth of healthy soft tissue.

Patients with Achilles tendonitis usually see good results between 8-12 weeks.

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