To heal Achilles tendinitis, physicians generally
prescribe a combination of the following treatments:
Rest
and activity modification – Relative rest
is generally prescribed to treat Achilles tendinitis.
You do not necessarily have to stay off your feet,
but you should decrease the duration and intensity
of your walking and running. Switching from a running
to a non-running sport, such as swimming, can reduce
stress to the Achilles tendon. Workouts involving
hills or sprinting should be avoided.
Ice
– Applying ice to your heel for about 20 minutes
three to four times a day can help reduce the inflammation,
especially after activity or therapy.
Non-steroidal
anti-inflammatory medications, like ibuprofen, are
sometimes prescribed to reduce pain and swelling
for seven to 14 days.
Stretching
– Successful treatment often requires routine
foot and ankle stretching two or three times a day.
Your physician or physical therapist can usually
show you a stretching routine to perform at home.
Physical therapy tends to be prescribed for more
severe cases of Achilles tendinitis. Before walking,
it is often helpful to stretch the back of your
lower leg, by pulling your toes back with your knee
straight and your ankle flexed towards you. Avoid
excessive stretching until your tendon pain decreases.
Proper
footwear – Shoes should have a stable heel,
a well-cushioned sole, and an adequate arch support,
depending on what type of foot you have. Many dress
shoes do not have adequate arch support and strain
the Achilles tendon. Your physician can recommend
the type of shoe that provides the best support
for the shape of your foot. Physicians often suggest
that patients wear padded sandals around the house
instead of going barefoot.
Orthotics/shoe
inserts – Your physician may suggest that
you wear orthotic inserts in your shoes to properly
support your foot. These inserts usually have an
arch support and a cushioned heel lift. Depending
on the shape of your foot, you may be able to buy
an over-the-counter heel cup or shoe insert, or
your physician may prescribe custom molded orthotic
inserts. Most people are instructed to wear the
inserts for at least six weeks.
Braces
– For severe or chronic tendinitis, some patients
wear a splint or cast to immobilize their ankle.
Heat
therapy – Whirlpool treatments, heat lamps,
hot showers, heating pads, heat ointments, and other
therapies like ultrasound stimulation may be suggested
by your physician.
To heal Achilles tendinitis as quickly as possible
and return to activities, your physician may recommend
that you schedule regular visits to a physical
therapist. However, many patients can strengthen
their ankles without formal therapy.
Your physician and physical therapist can design
a customized rehabilitation program with specific
stretching and strengthening exercises for your
calf muscles and feet. Most physicians recommend
a comprehensive leg-strengthening program to improve
your overall endurance and flexibility. Rehabilitation
exercises can usually begin when you can walk comfortably
without pain, which varies depending on your body’s
ability to heal and the extent of tendon damage.
Icing your Achilles tendon for 10 minutes before
and after exercise sessions may help reduce the
swelling and discomfort. Rehab usually begins with
stretching exercises for a period of weeks until
your Achilles tendon is flexible. Try to hold stretches
for about 30 seconds and repeat as pain allows.
Strength training usually starts within a month.
Initially, you will probably perform light exercises,
including picking objects off the floor with your
toes and flexing and extending your ankle. The resistance
gradually increases as your tendon heals. You can
usually return to activities when the range of motion
and strength are equal in the injured and healthy
ankle, when you can jog, sprint, and cut side-to-side
without pain, and you can jump and land without
pain.
Overuse and overtraining put you at high risk for
recurring Achilles tendinitis. Physicians generally
recommend that you avoid repetitive activities that
put constant strain on your Achilles tendon. Try
to incorporate cross-training into your workout
schedule. For example, instead of running every
day, alternate between running and swimming workouts.
Warm up before participating in activities and stretch
your calf muscles and feet both before and after
activities. You should increase the duration and
intensity of your workouts by no more than 10 percent
per week and avoid serious sprinting and hill climbing
until you have worked up to a high fitness level.
Choose athletic shoes that properly fit the shape
of your foot. Continue to wear orthotic inserts
and heel lifts if recommended by your physician.
If your ankle starts to hurt during exercise, you
should return to your physician’s office for
a check-up.
Rest
and activity modification – Relative rest
is generally prescribed to treat Achilles tendinitis.
You do not necessarily have to stay off your feet,
but you should decrease the duration and intensity
of your walking and running. Switching from a running
to a non-running sport, such as swimming, can reduce
stress to the Achilles tendon. Workouts involving
hills or sprinting should be avoided.
