| Insertional Achilles Tendinitis a very common complain among athletes. Often referred as heel pain as it mainly occurs at the lower heel, where the achilles tendon has its insertion. The pain sometimes can be so strong, that it is difficult to continue walking. |  The Achilles' tendon. PD image from Gray's Anatomy, from bartleby.com |
The causes for achilles tendinitis is in general thought to be physiological, mechanical caused. Often through "artificial" correction of the foot ankle (orthopaedic insoles, shoes, tapes etc.), also certain foot ankle position creates an unfavourable force on the ankle while running or jumping. Tight calf muscles is also believed to promote achilles tendinitis.
"Ankle Pronation Position" by Ducky2315 - Own work. Licensed under CC BY-SA 3.0 via Commons - https://commons.wikimedia.org/wiki/
Acute Heel Pain - What to do
If you experience any kind of trauma, with a popping noise, or an immediate, stating pain in your heel or above, stop immediately your activities and try the get home without putting any weights on the injured foot. Ask someone to assist you.
See a doctor asap to get a clear diagnosis. A sudden heel pain is usually more serious and can have different causes: sprain, rupture, or fractures are the most common.
Achilles tendonitis usually appears gradually and slowly over time. Usually there is a chronic underlying problem, which when irritated starts to become active and inflamed, causing pain an limits movements. Often it happens after some physical activities, which you didn't do for a long time and hours later you will feel a dull pain in your heel, which over time get's worse, if you keep on putting weight on it.
I still recommend people to see a doctor first to get a clear diagnosis. Self diagnosis are sometimes not so reliable. If you get the diagnosis achilles tendonitis or insertional achilles tendonitis by your doctor, it is up to you how you want to treat it.
The doctor most likely will recommend some nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and other pain killers. Sometimes shoe inserts to lift the heal and reducing the pressure on the heel are prescribed. Often physiotherapy is prescribed too.
I personally prefere a different way of treating it as described below.
See a doctor asap to get a clear diagnosis. A sudden heel pain is usually more serious and can have different causes: sprain, rupture, or fractures are the most common.
Achilles tendonitis usually appears gradually and slowly over time. Usually there is a chronic underlying problem, which when irritated starts to become active and inflamed, causing pain an limits movements. Often it happens after some physical activities, which you didn't do for a long time and hours later you will feel a dull pain in your heel, which over time get's worse, if you keep on putting weight on it.
I still recommend people to see a doctor first to get a clear diagnosis. Self diagnosis are sometimes not so reliable. If you get the diagnosis achilles tendonitis or insertional achilles tendonitis by your doctor, it is up to you how you want to treat it.
The doctor most likely will recommend some nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and other pain killers. Sometimes shoe inserts to lift the heal and reducing the pressure on the heel are prescribed. Often physiotherapy is prescribed too.
I personally prefere a different way of treating it as described below.
Treating achilles tendonitis
The typical home remedy for treating achilles tendonitis is using the RICE protocol, (Rest, Ice, Compression, Elevation). As stated in my blog "The Ice Dilemma" I don't favour Ice at all. Also the use of anti-inflammatory drugs I recommend not to use. If you have difficulty dealing with the pain , use some painkillers "prescribed" to take of the edge.
What I found what helps most in treating achilles tendonitis are:
What I found what helps most in treating achilles tendonitis are:
- Rest
- Movement
- Compression
- Massage
1. Rest
With rest I don't mean lying on the bed the whole day and watch TV. Thats a NO GO!!
With rest I mean get yourself some clutches, use them for a couple of days. Try not to put weight on your injured foot. Even slow and controlled walking seems to irritate the injured achilles even more. So give it some rest.
With rest I don't mean lying on the bed the whole day and watch TV. Thats a NO GO!!
With rest I mean get yourself some clutches, use them for a couple of days. Try not to put weight on your injured foot. Even slow and controlled walking seems to irritate the injured achilles even more. So give it some rest.
2. Movement
Movement is in my opinion the the second important thing to do. Starting by doing very light movements like extending und flexing your foot without resistance, in a sitting position. Best sit on a sofa, rest the leg on it and leave to foot hang freely in the air, than start moving it.
The exercise which helped me most are:
Eccentric one leg calf rises
Movement is in my opinion the the second important thing to do. Starting by doing very light movements like extending und flexing your foot without resistance, in a sitting position. Best sit on a sofa, rest the leg on it and leave to foot hang freely in the air, than start moving it.
The exercise which helped me most are:
Eccentric one leg calf rises
- Find a stair with handles on the side
- stand with the ball of foot on the stair, the rest of the foot is in the air.
- Stand up on your toes use the healthy foot to bring up the injured foot
- slowly let the heel sink all the way down
- repeat the same movement for 15 - 20 times, rest 30 - 60 sec. and repeat 2 - 3 more times
3. Compression
Compression can be helpful to try to restore the gliding ability of the fascia. Compression socks or elastic bands might be used to wrap up the foot/heel. I recommend to use compression in combination with movement. I don't tend to keep it the whole day on.
Compression can be helpful to try to restore the gliding ability of the fascia. Compression socks or elastic bands might be used to wrap up the foot/heel. I recommend to use compression in combination with movement. I don't tend to keep it the whole day on.
4. Massage
Massage, typically deep friction along the achilles tendon and over the heel helps breaking up sticky tissues.
Foam rollers can also be used to soften the calf muscles and tendons.
Massage, typically deep friction along the achilles tendon and over the heel helps breaking up sticky tissues.
Foam rollers can also be used to soften the calf muscles and tendons.
Hopefully you will feel soon better with this methods. But be aware of not to start immediately running again even if you don't feel any pain. Give it couple week to heel completely otherwise you will hurt yourself again.
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