Insertional Achilles Tendonitis Treatment

The Achilles tendon joins the calf muscle with the heel. It is the thickest, longest and strongest tendon of the body. However, this tendon is susceptible to injury due to a variety of factors, most notably the force generated by repetitive contact with a hard surface such as street running. The tendon also receives an inadequate amount of blood in proportion to the amount of work produced, possibly contributing to eventual trauma, especially as the individual ages. The area most susceptible to this type of injury occurs where the Achilles joins with the middle of the rear part of the heel--the insertion point.

Causes

• Insertional tendinitis is characterized by inflammation and pain surrounding the point where tendon and heel connect. This area experiences extreme stress during any movement that involves excessive stretching of the tendon or repetitive high-impact sports, producing either severe inflammation or possibly even the tearing or rupturing of the tendon. Although any individual engaged in physical activity, especially those of a repetitive nature such as running and dance, can experience insertional tendinitis, most reported cases involve overweight individuals in their fifties or sixties.

Symptoms

• An individual experiencing insertional tendinitis usually first detects tenderness directly over the Achilles tendon insertion area--around the back of the heel where the tendon joins the bone. Without proper treatment, this area experiences a gradient of discomfort during repetitive activity, resulted in constant tenderness and/or severe discomfort as the inflammation progresses. Over time, the individual can develop a hardening and thickening of the tendon, increasing the probability of a tear or rupture. In turn, this situation can also affect the range of motion of the angle joint, increasing the probability of associated ankle injuries.

Treatment Options

• Surgery intervention may be necessary for those cases in which the tendon experiences extreme and constant inflammation, or if the tendon loses adequate functional ability through hardening and/or thickening. However, for most cases, non-operative treatment includes rest, cross-training, icing the area, light stretching after the pain subsides and anti-inflammatory medication. Some individuals can benefit from physical therapy.

Prevention

• Medical professional recommend that individuals carefully select shoes that provide proper support--shoes that distribute striking force throughout the foot, and not be concentrated in the heel and Achilles insertion point. For some, orthotic intervention remains a possibility, such as heel lifts or foot-supporting insoles, to correct foot abnormalities that contribute to the situation.

  In addition, for women, most authorities discourage wearing high heels which shortens and tightens the calf muscles. This situation results in not only irritating the Achilles tendon, but can result in knee and hip problems.

WARNING:

• Medical experts agree that any pain or inflammation associated with the Achilles tendon needs to be immediately treated. Ignoring the situation can inflame the situation, leading to an increase in pain and/or severe injury such as a rupture or tear.