Achilles tendonitis, is a type of heel pain that is located on the back of your heel, rather than the bottom of your heel (plantar fasciitis). Achilles tendonitis can be categorized as insertional or non-insertional Achilles tendonpathy. ( -opathy is an general term for a problem, -itis refers to an actual inflammation)
Insertional Achilles Tendonopathy
The Achilles tendon attaches, or inserts, to the heel bone and sometimes a bone spur can develop (“Achilles tendon insertional calcification”) . Overtime, the bone spur can get large and make fitting into a shoe difficult or there is pain with nearly every step. There can be a pulling sensation with each step or a sensation of tightness that makes walking uncomfortable.
A conservative approach to acute pain includes, rest, a heel lift and over the counter anti-inflammatory medication. Once the pain subsides, physical therapy and custom orthotics is recommended for long term maintenance. In more chronic conditions, Dr. Tea offers a minimally invasive surgical solution to reduce the bump with just a 3mm incision. No hospital, no hardware, and you are able to walk after surgery.
Non-Insertional Achilles Tendonopathy
This is when there is pain and inflammation above the level of the heel bone, approximately 4 cm up the tendon. This is due to overuse and long term wear and tear of this can result in what the famous basketball legend Kobe Bryant suffered from, an actual tear. It is important to allow your body to heal itself with this condition by resting it. Heel lifts, boots, casting and/or custom orthotics are helpful initially. However, constant motion can cause microtears and eventual complete tear (rupture) so it is important to have this evaluated before it worsens.
Treatments for Achilles Tendonitis
Physical therapy is the cornerstone of treatment. Dr. Tea does not recommend steroid injections into the tendon, as this can weaken it and cause a complete tear. Amniotic fluid injection, however, improves healing without surgery through its regenerative properties. This unique injection contains bioactive proteins and growth factors to speed healing and alleviate pain.
Additional conservative options for Achilles tendonpathy is shockwave therapy. Click the link to learn more about this noninvasive office procedure to heal your pain.