An achilles tendonitis injury is very common among athletes and soccer players. It happens over 250,000 times each year in the United States alone. It can have a long recovery time if you don’t treat it right.





Fortunately there is a way to relief your pain. Even if you have calcification or a bone spur in your achilles tendon your pain can go away. But more about that later.

First I’ll tell you what the achilles tendon is, what it’s function is and how you can strectch your achilles tendon to relief your pain fast.

I’ll describe all the stretching exercises in detail, including video’s. This way you’ll be sure that you are performing them the right way. I’ll also describe the other treatment options you have for treating your achilles tendonitis injury.

So let’s start right now.

This is what you will learn today:

 

Achilles tendon anatomy

achilles tendonThe achilles tendon is the tendon that connects your calf muscles with your heel bone in your foot. It’s by far the strongest tendon in your body and almost impossible to tear.

The function of your achilles tendon is to transfer the forces produced by your calf muscle to your foot. It doesn’t apply any forces by itself. The main movement it assists is plantar flexion of your foot. This is the movement where you push your foot towards the ground.

That means that every time you stand on your toes, for example during walking  your calf muscles contract pulling on your achilles tendon.

When everything in your lower leg and foot works correctly this is not a problem. Your achilles tendon is strong enough to withstand these forces. But when the forces are too high, due to an accident, overuse or any other cause your achilles tendon can start to get damaged and irritated. Now you’ve developed an achilles tendonitis.


What is an achilles tendonitis?





When your achilles tendon is damaged, an inflammatory process starts. The purpose of this inflammation is to repair any damage in your achilles tendon. This is what we call an achilles tendonitis.

The symptoms of an achilles tendonitis are:

  • Pain
  • Swelling
  • Tightness
  • Redness
  • Increased temperature

This inflammation process is very common and happens anywhere in your body where there is damage.

For your achilles tendon, there are different things that can cause this damage.

What causes achilles tendonitis?

An achilles tendonitis is caused by overuse of the achilles tendon. When you run often, there are a lot of forces working on your achilles tendon. These forces cause micro traumas that usually are repaired by your body when it rests. But when you don’t take enough rest between your training sessions, these trauma’s don’t fully recover.

Also when you much longer than you normally do your achilles tendon can become overused causing the same effect.

This causes bigger trauma on your achilles tendon like little ruptures. When this happens, the inflammation process increases.

This is very well visible on an ultrasound image, like the one below. On the left image you can see a normal achilles tendon and on the right image you can see an achilles tendonitis. You can see that the tendon on the right is thicker than on the left.

achilles tendonitis





but overuse of your achilles tendon is not the only thing that can cause an achilles tendonitis.

Also a stiff ankle or shot calf muscles can causes these problem. I’l show you how.

Stiff ankle

Also reduced mobility of your ankle and your heel bone in particular, can cause an achilles tendonitis.

Because your achilles tendon is connected directly to your heel bone, a dysfunction can cause problems. When your heel bone can’t move in his full range of motion, your calf muscles have to pull harder on it to move it anyway.

This causes overuse of your achilles tendon leading to irritation or damage of your achilles tendon.

Also, shortening of your calf muscles can cause achilles tendonitis. When your calf muscles are too short, they pull harder on your achilles tendon. This can cause overuse and eventually damage.

This happens because your achilles tendon doesn’t receive the rest he needs to recover.

When you give it the proper treatment, the swelling will disappear and the achilles tendon will go back to its original size.

But when the tendinitis stays to long, fluid will appear around the tendon and in the bursa behind the achilles tendon. The function of this fluid is to protect the achilles tendon and to reduce the pressure.

This fluid contains calcium which is needed for the recovery.

Achilles tendon calcification

When you don’t give your achilles tendon the rest it needs, this calcium can stick together causing little blockes of calcium, called calcifications.

This caould be a problem because it tends to reduce the function of your achilles tendon.

So when this happens it can slow down your recovery.

Calcification of the achilles tendon looks like this:

 

achilles tendon calcifications





Fortunately, calcification of the tendon doesn’t always have to be a cause for pain or disfunction. The woman I made this ultrasound image of, had the same calcification on her other achilles tendon. But this side she didn’t experience any pain. This means that even long existing achilles tendonitis can become pain free.

Long lasting achilles tendonitis is also known to cause plantar fasciitis.

So now you know what causes an achilles tendonitis, it’s time to start with the proper treatment.

Achilles tendonitis treatment with 4 stretching exercises

achilles tendonitis night splintSo when you have confirmed that you suffer from achilles tendonitis, it’s time to start your treatment right away. The first thing you should do is reduce your activities as much as possible.

That means no running for a few weeks and walk as little as possible. Bike riding however is not a problem.

Also wearing proper shoes can help a great deal. This means firm heavy shoes, like hiking shoes. The shoes you shouldn’t wear are high heel, sandals or flip flops. They don’t provide proper support and won’t reduce the overuse of your achilles tendon.

Along with rest, we have to cure the causes for your achilles tendonitis as discussed earlier.

The treatment is based on removing the possible causes of your achilles tendonitis.





That’s why the treatment consists of two stretching exercises, one mobility exercise and one strength exercise. These are all exercises you can do at home without any equipment.

You can also wear a night splint to stretch your achilles tendon during the night. This will make it easier to start in the morning and will help your recovery. I would recommand this night splint because it puts a good amount of pressure while letting you sleep comfortable.

When this home treatment doesn’t work for you, I’ll also discuss all the other options you have to cure this pain.

But first I’ll start with the stretching exercises:


Achilles tendonitis stretching exercise 1: Achilles tendon stretches.

The first achilles tendonitis stretching exercise is designed to stretch your achilles tendon. By stretching your achilles tendon you can reduce the pressure applied on your achilles tendon. This will give it rest and the possibility to recover.

Perform the exercise the following way:

  • Stand with your two feed in a straight line with your painful achilles tendon behind
  • Make sure your feet are pointing forward
  • Now bend the knee of your painful side and place your entire weight on it
  • Now you should feel the stretch in your achilles tendon
  • Hold this for 15 seconds

You can find the exercise also in the following YouTube video. This way you know how to perform it correctly.

Repeat this exercise several times a day.

Achilles tendonitis stretching exercise 2: Calf muscle stretches

The second tendonitis stretching exercise is designed to stretch your calf muscle. As you know by now, your calf muscle influences your achilles tendon. By increasing its size, you’ll reduce the forces it applies on your achilles tendon.

Perform the exercise the following way:

  • Stand in the same position as during the first exercise.
  • Now extend the knee of your painful side and bend the other one
  • Move your hips forward with your knee still extended and your heel on the ground
  • You should feel the stretch in your calf muscleHold this for 15 seconds

You can find the exercise also in the following YouTube video. This way you know how to perform it correctly.

Repeat this exercise several times a day.

Achilles tendonitis stretching exercise 3: Increase the mobility of your ankle

Togheter with stretching your achilles tendon and calf muscles, you can reduce the pressure on your achilles tendon even further by increasing the mobility of your ankle.

That’s exactly what we will do with this next exercise.

Perform the exercise the following way:

  • Stand on the toes of your painful foot
  • Now make circles with your ankle while keeping your toes on the same place
  • Make the circles as big as possible
  • Now do the same the other way around
  • Repeat it for two minutes for each direction

You can find the exercise also in the following YouTube video. This way you know how to perform it correctly.

Repeat this exercise several times a day.

Achilles tendonitis stretching exercise 4: Increase the strenght of your achilles tendon and calf muscle

When the tension on your achilles tendon is reduced through these exercises and the pain reduces, it’s time to start training.

By training the strength of your achilles tendon and calf muscle you will support the healing process. This will reduce your recovery time.

Perform the exercise the following way:

  • Stand on two feet at shoulder width
  • Now stand on your toes
  • And slowly come down
  • Repeat this 10 times

You can find the exercise also in the following YouTube video. This way you know how to perform it correctly.

It’s important not to start to soon with this exercise. If the conditions are not right yet, it will increase pain rather than reduce it. It might cause a little pain during the exercise, but it shouldn’t cause more pain when you’re finished. Also you shouldn’t feel a reaction later in the day.

This way you know your achilles tendon is good enough for this exercise. Now you can slowly try to increase it. You can do this by repeating it 15 or even 20 times.

Later, when it’s going really well, you can also try to perform the exercise on 1 leg. When you’re able to do this, you know that your achilles tendon is almost completely healed.

With these exercises most people will be able to recover completely within 8 weeks. However, some need more help. I’ll discuss your options now.


Other achilles tendinitis treatment options

If these exercise didn’t work enough for you there are a few other options that can help you. These options are also aimed on reducing the causes of your achilles tendonitis.

Physical therapy

The first thing your should do is to visit a physical therapist nearby. He can help you through massage or Dry Needling to reduce the tension in your calf muscle. This will reduce the forces on your achilles tendon.

He can also increase the mobility of your heel bone by mobilizing it. This will be more effective than the exercise and sometimes necessary to loosen your ankle joint.

Shockwave therapy





When regular physical therapy also didn’t help you enough, shockwave therapy might be beneficial for you.

The purpose of shockwave therapy is to remove the calcification in your achilles tendon. As you know, calcification can be a cause of achilles tendonitis, but it can also be a symptomatic. However, when all options have failed so far, it’s time to address the calcification.

When the calcification is not to solid, it can be crushed by shockwave therapy. It will weaken the calcification. This way it will fall apart and reabsorbed by your body.

The treatment is relatively painful and no success can be guaranteed.

Achilles tendon Surgery

Your last resort should be surgery. If everything has failed so far and you’re still in substantial pain, you can consider surgery.

During the surgery, the surgeon will remove any damaged tissue, calcification or bone spurs. This will make sure that tendon is totally clean again after the surgery.

Unfortunately there is no 100% guaranteed success that you will be pain free after surgery.  Also the recovery time can take up to several months before you’ll be able to do everything you want.

Conclusion

I’ve described several treatment options for achilles tendonitis.  You should be able now to make a good decision about your best treatment options. If you still have any questions, feel free to send me an e-mail at info@alwaysfysio.nl.

If you found this information useful feel free to share it with your friends.