‘Sore Heel Pain when Walking’ – Achilles Tendonitis
If you suffer from burning or piercing pain into the tendon above the heel bone of your foot, then you may be suffering from a condition known as Achilles tendonitis. Achilles tendonitis is a condition where the large tendon of the lower leg which attaches to the heel bone becomes inflamed and sore. This leads to burning shooting pain occurring during walking and running activities that cause stress to the tendon. Indeed burning pain can be felt when getting out of bed in the morning time or when walking after been seated for a prolonged period.
Achilles Tendonitis can commonly be caused by a sudden increase in walking or running activity coupled with tight inflexible calf muscles. This leads to the Achilles tendon becoming stressed resulting in the development of micro tears in the fibrous treads of the tendon. These tiny tears can harden and swell overtime leading to a hardening of and poor elasticity in the Achilles tendon. On movement the tendon is then stressed, producing this burning shooting pain.
Signs & Symptoms
Pain into the Achilles tendon both during and after a long walk or when out jogging
Stiffness and pain eases at the start of the activity but gradually worsens during the activity
Tight calf muscle, tenderness felt when pressing on Achilles tendon
Patient is by overweight and has fallen arches in his feet
Stiffness felt in the morning when getting out of bed. Stiffness can also be felt before or after walking or running session.
Activities that cause Achilles tendinopathy:
Many years of running / walking with tight calf muscles and restricted ankle joints.
Running / walking on uneven road surfaces
Weakness in calf muscles & poor running technique
Poor footwear or a change of footwear
Excessive falling inwards of the foot (pronation) when walking or running.
Treatment & Management
When the Achilles is overloaded there is not enough of blood circulation to the tendon resulting in weakening of the tendon with microscopic scarring and tearing occurring within the tendon. Patients who attend my clinic with Achilles Tendonitis are instructed to ice the tendon on several occasions throughout the day. A small heel raise is often inserted in their shoe in order to reduce the tensile stress on the tendon when walking thus allowing healing to occur. Treatment to stretch out the tightened calf muscles is essential coupled with mobilisations to the restricted joints of the foot and ankle. Phased local friction soft tissue massage coupled ice to tendon also. The next step to fully rehabilitating the Achilles tendon involves the patient undergoing a series of graded eccentric strengthening. These exercises should be performed under the guidance of your Physical therapist.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
Contact Number: 0504 26672
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