Achilles tendinitis is a common condition that causes pain along the back of the leg near the heel.
The Achilles tendon is the largest tendon in the body. It connects your calf muscles to your heel bone and is used when you walk, run, and jump.
Although the Achilles tendon can withstand great stresses from running and jumping, it is also prone to tendinitis, a condition associated with overuse and degeneration.
Simply defined, tendinitis is inflammation of a tendon. Inflammation is the body’s natural response to injury or disease, and often causes swelling, pain, or irritation. There are two types of Achilles tendinitis, based upon which part of the tendon is inflamed.
Noninsertional Achilles Tendinitis
In noninsertional Achilles tendinitis, fibers in the middle portion of the tendon have begun to break down with tiny tears (degenerate), swell, and thicken.
Tendinitis of the middle portion of the tendon more commonly affects younger, active people.
Insertional Achilles Tendinitis
Insertional Achilles tendinitis involves the lower portion of the heel, where the tendon attaches (inserts) to the heel bone.
In both noninsertional and insertional Achilles tendinitis, damaged tendon fibers may also calcify (harden). Bone spurs (extra bone growth) often form with insertional Achilles tendinitis.
Tendinitis that affects the insertion of the tendon can occur at any time, even in patients who are not active.
Achilles tendinitis is typically not related to a specific injury. The problem results from repetitive stress to the tendon. This often happens when we push our bodies to do too much, too soon, but other factors can make it more likely to develop tendinitis, including:
- Sudden increase in the amount or intensity of exercise activity—for example, increasing the distance you run every day by a few miles without giving your body a chance to adjust to the new distance
- Tight calf muscles—Having tight calf muscles and suddenly starting an aggressive exercise program can put extra stress on the Achilles tendon
- Bone spur—Extra bone growth where the Achilles tendon attaches to the heel bone can rub against the tendon and cause pain
Common symptoms of Achilles tendinitis include:
- Pain and stiffness along the Achilles tendon in the morning
- Pain along the tendon or back of the heel that worsens with activity
- Severe pain the day after exercising
- Thickening of the tendon
- Bone spur (insertional tendinitis)
- Swelling that is present all the time and gets worse throughout the day with activity
If you have experienced a sudden “pop” in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon. See your doctor immediately if you think you may have torn your tendon.
In most cases, nonsurgical treatment options will provide pain relief, although it may take a few months for symptoms to completely subside. Even with early treatment, the pain may last longer than 3 months. If you have had pain for several months before seeking treatment, it may take 6 months before treatment methods take effect.
Rest. The first step in reducing pain is to decrease or even stop the activities that make the pain worse. If you regularly do high-impact exercises (such as running), switching to low-impact activities will put less stress on the Achilles tendon. Cross-training activities such as biking, elliptical exercise, and swimming are low-impact options to help you stay active.
Ice. Placing ice on the most painful area of the Achilles tendon is helpful and can be done as needed throughout the day. This can be done for up to 20 minutes and should be stopped earlier if the skin becomes numb. A foam cup filled with water and then frozen creates a simple, reusable ice pack. After the water has frozen in the cup, tear off the rim of the cup. Then rub the ice on the Achilles tendon. With repeated use, a groove that fits the Achilles tendon will appear, creating a “custom-fit” ice pack.
Non-steroidal anti-inflammatory medication. Drugs such as ibuprofen and naproxen reduce pain and swelling. They do not, however, reduce the thickening of the degenerated tendon. Using the medication for more than 1 month should be reviewed with your primary care doctor.
Exercise. The following exercise can help to strengthen the calf muscles and reduce stress on the Achilles tendon.
- Calf stretch Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
Physical Therapy. Physical therapy is very helpful in treating Achilles tendinitis. It has proven to work better for noninsertional tendinitis than for insertional tendinitis.
Eccentric Strengthening Protocol. Eccentric strengthening is defined as contracting (tightening) a muscle while it is getting longer. Eccentric strengthening exercises can cause damage to the Achilles tendon if they are not done correctly. At first, they should be performed under the supervision of a physical therapist. Once mastered with a therapist, the exercises can then be done at home. These exercises may cause some discomfort, however, it should not be unbearable.
- Bilateral heel drop Stand at the edge of a stair, or a raised platform that is stable, with just the front half of your foot on the stair. This position will allow your heel to move up and down without hitting the stair. Care must be taken to ensure that you are balanced correctly to prevent falling and injury. Be sure to hold onto a railing to help you balance.Lift your heels off the ground then slowly lower your heels to the lowest point possible. Repeat this step 20 times. This exercise should be done in a slow, controlled fashion. Rapid movement can create the risk of damage to the tendon. As the pain improves, you can increase the difficulty level of the exercise by holding a small weight in each hand.
- Single leg heel drop This exercise is performed similarly to the bilateral heel drop, except that all your weight is focused on one leg. This should be done only after the bilateral heel drop has been mastered.
Cortisone injections. Cortisone, a type of steroid, is a powerful anti-inflammatory medication. Cortisone injections into the Achilles tendon are rarely recommended because they can cause the tendon to rupture (tear).
Supportive shoes and orthotics. Pain from insertional Achilles tendinitis is often helped by certain shoes, as well as orthotic devices. For example, shoes that are softer at the back of the heel can reduce irritation of the tendon. In addition, heel lifts can take some strain off the tendon.
Heel lifts are also very helpful for patients with insertional tendinitis because they can move the heel away from the back of the shoe, where rubbing can occur. They also take some strain off the tendon. Like a heel lift, a silicone Achilles sleeve can reduce irritation from the back of a shoe.
If your pain is severe, your doctor may recommend a walking boot for a short time. This gives the tendon a chance to rest before any therapy is begun. Extended use of a boot is discouraged, though, because it can weaken your calf muscle.
Extracorporeal shockwave therapy (ESWT). During this procedure, high-energy shockwave impulses stimulate the healing process in damaged tendon tissue. ESWT has not shown consistent results and, therefore, is not commonly performed.
ESWT is noninvasive—it does not require a surgical incision. Because of the minimal risk involved, ESWT is sometimes tried before surgery is considered.
Ginger for Tendonitis Relief
Using Ginger to Relieve Tendonitis
Ginger is a perennial plant which is grown in tropical climates such as China, Jamaica and India. It is used as a culinary spice and has also been used as a traditional medicine in Asia and India since ancient times. It has a long folk history in Asia as a popular treatment of bursitis. In the West it has been used for treating tendonitis and also bursitis.
Ginger is used to reduce symptoms of tendonitis because it has both anti-inflammatory effects as well as pain-relieving properties. Ginger works by inhibiting the production of inflammatory chemicals. A compound in ginger called 6-shogaol has been shown to reduce pain by blocking transmission of pain signals. Ginger has also been known to reduce inflammation of the joints and muscle tissue as it improves circulation.
Ginger can be taken by capsules, tincture, teas or ground ginger root. Rubbing ginger essential oil on sore tendons can also help to alleviate the pain as well as easing stiffness. The maximum daily dose of ginger recommended is 4 g. Taking pills instead of powder can reduce possible stomach upset sometimes associated with ginger. Physicians have also recommended that individuals with gallbladder disease do not use ginger.
Naturopathic (Natural) Treatment for
In some cases, Achilles tendonitis, also sometimes called Achilles tendinitis or inflammation of the Achilles tendon, can be treated naturally with various anti-inflammatory agents. An anti-inflammatory diet can decrease discomfort and reduce systemic inflammation and the risk for associated diseases.
An anti-inflammatory diet is based on the following foods:
- Include: fresh vegetables and fruits, flax seed meal, flax seed oil, deep water fish, fresh water, organically raised foods
- Avoid: sugar, refined white flour products (e.g., pasta and bread), processed foods, fast food, saturated animal fats (red meat and dairy products)
Nutritional and herbal anti-inflammatory supplements include:
How to Make a Bath Treatment forTendonitisThis gentle bath soak treatment is perfect for tendonitis. Tendonitis is the inflammation of a tendon. Symptoms of tendonitis often include swelling, stiffness, pain and sometimes a burning sensation surrounding the tendon. This bath treatment works by helping to relieve the symptoms, and helping to treat the inflammation of tendonitis
- Manganese: 25 to 100 mg twice a day for the first 2 weeks after injury, then 10 to 15 mg twice a day
- Selenium: 100 to 200 mcg daily
- Vitamin E: 400 IU daily
- Flax seed oil: 1 to 2 tsp daily
- Bromelain: 400 mg 3 times a day, not with food
- Wobenzyme tablets: 5 tablets 3 to 5 times a day, not with food.
Things You’ll Need
1/4 Cup of Celtic Sea Salt
5 Drops of Cypress Oil
5 Drops of Eucalyptus Oil
- 5 Drops of Chamomile Oil
- 1In a small mixing bowl, gently stir together the celtic sea salt with the cypress oil, eucalyptus oil and chamomile oil. Use either a wooden or plastic spoon or spatula, but avoid using any metal utensils if possible.
Run a warm bath. Ideally, the water should be around 100 degrees but not much hotter than that. Water that is too hot will weaken the essential oils used in the treatment.
Gently pour the salt mixture under the running water. Once the salt appears to have dissolved, settle in to the bath. Soak in the treatment for a total of around thirty minutes.
I suggest using the treatment daily until the tendonitis has healed.
Natural Home Remedies For Tendonitis
Soak a spoonful every night and consume in the morning.
- Rest: first and foremost, rest is very crucial. Do not move the affected part for some time. It does not mean that you stop all activity, only do not exert the affected part too much.
- Ginger: ginger tea is recommended for most pains and inflammations. Boil grated ginger in a cup of water, for 15 minutes, consume once daily. The root supplies loads of anti inflammatory agents called gingerols that are known to decrease the inflammatory process appreciably, and consequently ease pain.
- Garlic: have 2 flakes of raw garlic daily for a week. The pain and swelling will begin to subside quickly.
- Black sesame seeds: black sesame seeds are really effective for pains and stiffness, associated with tendonitis.
- Massage therapy: is recommended. Ensure that your therapist knows your complete health history. Massage helps alleviate pain, discomfort, swelling and stiffness, and improves flexibility. Using essential oils such as clove, lavender, blended with a carrier oil, will afford speedy relief.
Baking Soda for Tendonitis
Baking soda is known to help manage pains and cramps. It especially helps combat muscle fatigue which may be associated with the condition. However, do not take large quantities of baking soda; it comes with a host of side effects.
Exercises For Tendonitis In Heels
The following exercises are highly beneficial to manage tendonitis of the heel tendon, the tendon that is most commonly affected.
- Lie down and place both legs on top of one another. Tighten the muscle on the top of the thigh, then lift the leg off ground to make 45 to 60 degree angle with the leg below. Do not flex either leg at the knee. Count 20 and then release the posture and repeat 3 times.
- Using the wall or a chair as support, raise your body and balance all the weight on your toes. Count 10 and slowly come back to the initial position. Repeat 5 times. Once the pain decreases, try to bring one leg down at a time, and balance all your weight on to one leg.
- Use the wall or a chair for support. Slowly pull the heel of the injured leg towards the buttocks. Hold the position for 15 seconds. Repeat this exercise about 5 times.
Ice application is recommended by doctors and experts. However, do not apply the ice directly. Use either an ice bag, or place the ice cubes in a cloth and place the cloth over the inflamed area. Place the ice bag for 15 minutes, repeat at least 5 to 6 times daily. Ice reduces inflammation, swelling and pain speedily.
Acupressure for Achilles Tendonitis
Acupressure for Bone Spurs