What is Achilles Tendonitis?
Achilles tendonitis is inflammation along the Achilles tendon found on the back of the lower leg attaching the calf muscles to the heel bone. The Achilles tendon is the largest tendon in the body and is responsible plantarflexion of the ankle (causing the front of the foot to lower and lift the heel off the ground). Achilles tendonitis is typically caused by overuse (running and jumping type exercises).
What are causes of Achilles Tendonitis?
Achilles Tendonitis is usually due to overuse, but this tends to happen in specific situations:
• Sudden increase in the amount or intensity of activity
• Tight calf muscles
• Running on hard surfaces such as concrete
• Running too often
• Frequent jumping activities (such in volleyball or basketball)
• Using shoes with improper support
How is Achilles Tendonitis Diagnosed?
Typically only a physical exam is needed to diagnose Achilles Tendonitis. In some more involved cases Diagnostic Ultrasound and even an MRI may be warranted.
What is the treatment for Achilles Tendonitis?
Most cases of Achilles Tendonitis can be treated conservatively. This involves a number of modalities including:
• Decreasing or stopping all high impact activity until the acute inflammatory phase has passed.
• Running or walking on softer or smoother surfaces.
• Switching to swimming or biking for aerobic activity
• Stretching exercises
• Strengthening exercises with eccentric contractions of the Achilles.
• Heel lifts in the shoes
• Foot Orthoses
If you are suffering from any foot pain, see The Podiatrist.
Every time you take a step, your foot is hit with unforgiving vibrations that can cause tendinitis, plantar fasciitis, stress fractures, and more — particularly if you wear high heels or participate in foot-stressing activities, like running.
The muscles in your foot play a huge role in how your body absorbs shock.
To start an at-home foot health routine to reduce pain, try these four moves:
• For strength: Short foot. This is a movement so small, To perform the short foot exercise, stand barefoot and contract the arch of your foot by driving your big toes into the ground. It makes the bottom of the foot contract, it pulls your arch up, and fires your hips and abs — just from that one little movement. “Short footing” a few times a day while you’re doing another activity like brushing your teeth, cooking dinner, or waiting for the bus.
• For strength: Stand on one leg. Now that you know the benefits of single-leg training, try it at home by simply standing barefoot on one foot while standing in line or doing chores around the house. For an extra balance challenge that will really fire your feet, close your eyes — it throws off your centre of gravity and makes balancing more challenging.
• For recovery: Stand on golf balls. Golf balls under your feet work the same as foam roller and massage for other parts of your body-hey break up lactic acid to help muscles relax and recover from stress. If standing on the balls is too intense for you, sit in a chair and roll the golf balls under your feet for a light massage. This exercise can be helpful for arch pain, cramps, and foot pain from plantar fasciitis.
• For recovery: Calf stretches. Tight calves put a lot of strain on your feet, which is why The Podiatrist recommends stretching your calves daily. For a simple stretch, face a wall from two to three feet away. Lean into the wall, keeping your heels on the floor and your knees extended, and hold. For a deeper stretch, stand on one leg on a stair, holding a railing for support. Drop your heel, so that it hangs off the step, and push it down with your weight until you feel a stretch in your calf.
Contact The Podiatrist for any of your foot problems.
Children are resilient, but when your child begins to complain about heel pain, this must be taken seriously. Heel pain in a child is not normal. There are different causes of heel pain in a child and an adequate physical exam can help determine which type of heel pain is affecting your child.
What Is Calcaneal Apophysitis?
The most common cause of pediatric heel pain is calcaneal apophysitis (an injury or irritation to the growth plate of the heel). Typically, this occurs in boys (and girs) between the ages of 8 and 13 who are fairly active children. This is most likely to occur with a rapid increase in activity after a period of rest – such as starting rugby, soccer, netball and any in fact and sport practice after being off for a peiod of time.
Are There Other Causes of Pediatric Heel Pain?
Yes. Calcaneal apophysitis is the most common cause of pediatric heel pain. However, there are other things that can cause the heels to hurt such as stress fractures, growth plate fractures and hematagenous osteomyelitis, an infection of the heel bone.
Causes of Calcaneal Apophysitis
Causes of pediatric heel pain include:
- Rapid increase in physical activity (sports)
- Changes in training surfaces
- Changes in training techniques
- Changes in shoe gear (or going barefoot) while being physically active
- A rapid increase in growth over a short period of time
During periods of rapid growth, the bones of the leg grow faster than the soft tissues (muscles, tendons and ligaments) and the stress they place across the growth plate can cause pain and inflammation.
Symptoms of Calcaneal Apophysitis
Calcaneal apophysitis typically affects active boys and girls between the ages of 8 and 13; however, this condition can affect any active child. Early signs and symptoms include:
- Inability to participate in athletic activities
- Walking on the toes to keep the heel from touching the ground
- Pain in the heel that is worse after activity and relieved by resting
The Podiatrist will start your exam with a thorough history. This will be followed by a physical exam. During your physical exam, The Podiatrist:
- Pain and tenderness to the area of the inflamed growth plate
- A tight heel cord (Achilles tendon)
- Overall foot structure
- Abnormalities in gait
X-rays may be ordered to detect any underlying bone abnormalities.
Calcaneal apophysitis can be easily treated with changes in shoe gear, resting, icing, stretching and anti-inflammatory medications. Sometimes, physical therapy may be necessary, but this is rare.
Many times these types of injuries are unavoidable, but proper athletic shoes, stretching exercises and avoidance of obesity are some of the ways one can prevent an injury to the growth plate.
See The Podiatrist for expert care.