Updated: May 11
Ankle pain can make simple tasks, like getting out of bed in the morning, difficult. Achilles tendinitis, a common condition that causes pain in the back of your ankle, may become chronic if left untreated.
Many patients prefer not to rely on pain medication or injections, due to the many health concerns associated with them. If you have Achilles tendinitis, this article will show you how it can be treated with non-surgical and non-pharmaceutical methods.
Achilles tendinitis is when your Achilles tendon, which is at the back of your ankle, becomes inflamed. The tendon doesn’t have a strong blood supply, making it vulnerable to injury and, when an injury is sustained, slow to recover. There are several common causes of Achilles tendinitis:
Biomechanical abnormalities. Structural imperfections, such as flatfoot, valgus knees and leg length differences can place excessive stress on your Achilles tendon, causing inflammation.
Insufficient warm-up. Physical activity that involves repetitive ankle movements, such as jogging, basketball and tennis, increases the workload of your Achilles tendon. Thorough warm-ups before physical activity prepare your muscles and tendons by increasing blood supply, thus reducing the risk of injury.
Obesity. On each step you take, 3 to 6 times your body weight is transferred through you leg to your ankle and foot. Excess body weight increases the risk of developing many lower limb injuries, including Achilles tendinitis. Research shows that overweight people have structural changes in their Achilles tendon, which impairs its function and increases the likelihood of injury.
Medical conditions. Autoimmune conditions, where your body’s immune system attacks your own tissues, may cause inflammation in many areas, including your Achilles tendon.
As with many inflammatory disorders, the symptoms of Achilles tendinitis are usually worse in the morning:
Pain. Achilles tendinitis may cause pain in your calf, the back of your ankle, your heel bone or the bottom of your foot. The pain may be mild or severe.
Swelling. Your Achilles tendon may swell.
Weakness. Muscles waste away within days of reduced use. Due to your pain, you may unconsciously place less stress on your affected leg, causing its muscles to weaken. Additionally, pain itself reduces neural input and directly affects muscle strength.
When to Seek Immediate Medical Attention
If you experience any of the following symptoms you should seek immediate medical attention:
Pain that is severe or pulse-like
Significant swelling in your leg
Pain that isn’t alleviated by rest
Numbness or tingling in your leg
Your doctor will perform a physical examination and ask you some questions. If necessary, you’ll be referred for further examinations, such as an ultrasound or an MRI scan. This will help determine the extent of tissue damage, and rule out other causes of leg pain.
Your body is a single unit, all of its joints working together to perform movements in their most efficient way. When treating Achilles tendinitis, overall postural misalignment should be addressed, and correct footwear should be used. Acupuncturists, Osteopaths and Physical Therapists are trained in these areas.
Specific treatment modalities for Achilles tendinitis include:
Chinese acupuncture. Practitioners of Chinese medicine aim to rebalance your body’s energy, a concept that isn’t recognized in conventional medicine. Acupuncturists accomplish this by inserting small needles into various points. Research demonstrates that acupuncture accelerates recovery and reduces pain in patients with Achilles tendinitis.
Physical therapy. Physical therapists aim to restore muscle strength, increase flexibility and improve blood circulation to damaged tissues. Research at the Royal surrey County Hospital, in the UK, showed that physical therapy significantly reduces symptoms of Achilles tendinitis. The research focused specifically on manual techniques that release the calf muscle. Relaxed muscles receive more blood than tight muscles, so your body’s recovery mechanism is accelerated when tense muscles are released.
Low level laser therapy (LLLT). In LLLT a gentle laser beam is focused on damaged tissue, which affects cellular processes, reducing inflammation. A study at Surugadai Nihon University Hospital, Tokyo, demonstrated that LLLT is especially effective in treating Achilles tendinitis. Physicians, physical therapists and chiropractors are among those who use this method.
Painkillers and steroid injections are associated with negative health effects. Therefore, with your doctor’s approval, you should use conservative methods for the initial treatment of Achilles tendinitis.
1. Wearing SC, Hooper SL, Grigg NL, Nolan G, Smeathers JE (2013). “Overweight and obesity alters the cumulative transverse strain in the Achilles tendon immediately following exercise”. J Bodyw Mov Ther 17 (3):316-21.