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 (calcaneus) and sometimes a bone spur can develop. 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 longterm maintenance. In more chronic conditions, the bone spur is shaved down to provide relief.
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 longterm 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.
Dr. Tea does not recommend steroid injections into the tendon, as this can weaken it and cause a complete tear. Additional conservative options for noninsertional Achilles tendonpathy is shockwave therapy. Click the link to learn more about this noninvasive office procedure to heal your pain.