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
sport to swimming can reduce stress to the Achilles
tendon. Workouts involving hills or sprinting should
usually be avoided. In short, don't do
what hurts.
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. Medications such
as ibuprofen are sometimes prescribed to reduce
pain and swelling for seven to 14 days. Stronger
pain medication is rarely prescribed.
Stretching
– successful treatment often requires routine
foot and ankle stretching to be done 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 – at your physician’s discretion,
you may need to wear orthotic inserts in your shoes
to properly support your foot. The inserts usually
have an arch support and a suctioned heel lift.
Depending on the shape of your foot, you may be
able to buy an over-the-counter heel cup or shoe
insert. 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 physical therapist.
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.
Your physician and physical therapist can design
a custom 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 ten minutes before
and after exercise sessions may help ease pain.
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.
