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Rehab for Achilles Tendinitis


When I was in college I had my fair share of running injuries…mostly because I didn’t stretch enough. I developed Achilles tendinitis, which is an inflammation of the Achilles tendon, the thick, fibrous tendon that travels from the calf muscles along the back of the ankle.

When the Achilles becomes inflamed, there is less space within the connective tissue sheath that surrounds it. It can feel squishy, or even like it gets stuck as you try to flex and point the foot, due to adhesions that develop. These prevent the tendon from gliding smoothly. The pain can be mild or severe, and is worse during the push off phase of walking or running, or any time you point the foot and toes downward.

Often, there is associated weakness in the Achilles and possibly weakness in the anterior muscles of the shin, with tightness in the calf and Achilles. Both stretching and contracting of the calf muscles may reproduce pain.

Managing this type of injury requires frequent icing to reduce inflammation. Rest is also key. High impact activities, particularly any sports that involve running or jumping should be avoided. Cross friction massage is also very beneficial to improve circulation and reduce adhesions and promote optimal alignment of collagen fibers. It may be that flat feet or high arches contributed to the problem, and orthotics may be helpful in restoring better alignment to the foot and ankle. There are also braces and night splints available for more severe cases that allow the calf muscle to rest and have a gentle sustained stretch. Frequent active stretching of the gastracnemius and soleus, the 2 muscles that form the Achilles tendon, is also essential.

Seeking treatment early will help prevent a chronic inflammation from developing. Physical therapy can be very helpful in correcting any muscles imbalances, retraining the joint receptors, and helping to reduce inflammation with various modalities (such as ultrasound, iontophoresis, and electric stimulation). A PT can also help develop a sports specific rehab program to help get you back to your sport safely and as quickly as possible, teaching you ways to avoid the same condition in the future.

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