Achilles tendonitis commonly occurs as a result of shearing forces placed on the Achilles tendon where it attaches to the heel bone. Initially pain is experienced first thing in the morning or after activity and if left untreated symptoms may progress to unrelenting pain at the back of the heel.
The two main causes are overuse and falling arches in the feet, putting undue pressure on the Achilles tendon from excess inward rotation of the heel and therefore the rest of the foot. It can also be aggravated by a high heel tab on a running shoe and lack of calf stretching before and after exercise.
Initial treatment should be the use of an ice pack for 10-15 minutes a day and if there is an underlying problem of excess inward rotation of the foot, this should be corrected with custom made orthotic insoles. Also footwear should be checked to see if there is any irritation caused by them. Other physical therapies, such as strapping, ultrasound and hot and cold foot baths are common treatments. The tendon should be gently stretched and massaged to try to remove any bumps of scar tissue which would provide an on-going area of weakness. A slight heel raise placed inside the shoe to remove some pressure from the tendon may also be helpful. All serious exercise should be avoided until recovery is complete. After the injury is resolved a rehabilitation programme for the muscles and tendons is important in the form of a regime of stretching and exercise.