As I begin my exercise routine for the summer my Achilles tendonitis kicks in. It shouldn’t surprise me but it does every time. It’s the pain in my heel that reminds me that I shouldn’t take too much time off of exercise and shouldn’t jump back into it too aggressively when I do.
Achilles tendonopathy/tendonitis affects many people usually starting in the middle thirties and peaking in middle age. It starts as a dull ache or tightness in the heel or lower calf and becomes progressively more uncomfortable with increased activity. Severe cases can even lead to rupture of the tendon. Achilles tendinitis is typically not related to a specific injury. The problem usually 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: anatomic features, genetic predisposition, smoking, and diabetes.
For me as in most cases, conservative treatment provides pain relief, although it may take a few months for symptoms to completely subside. The first prescription I give myself is REST. I stop the activities that make the pain worse. For me that is typically running but really any high-impact exercises need to be slowed or stopped. I then concentrate my workouts on low-impact activities like the stationary bike, elliptical training and swimming that put less stress on the Achilles tendon. I also find and recommend icing to my patients. I place the ice on the most painful area of the Achilles tendon for up to 20 minutes and try to do it several times a day until the inflammation comes down. I also find calf stretching after a short warm up and again post exercise very helpful. When I carefully follow my own advice ,my symptoms usually go away in a month or two.