The calf muscles are attached to the heel by the Achilles tendon. This is primarily the thickened cord or fibrous band that runs down the back of one’s leg and attaches to the heel bone.   The main function of this complex is to force the foot downward in gait and thus propel one forward.  Achilles tendonitis is a common diagnosis for all podiatrists and Dr. Sowell is no different.  Athletes, housewives, factory workers and professionals are just a few of the types of patients who suffer from Achilles tendonitis.  The cause may be varied.  Sometimes it is to injury from a direct impact, from over-use or excessive training, or can just start hurting as a result of shoe pressure.  The patient with an Achilles tendonitis will most often have pain and swelling in the lower portion of the tendon just above the heel, will have discomfort when moving the foot upwards thus stretching the tendon, and will probably note that the condition has worsened over time.

It is hard to predict who will suffer from Achilles tendonitis but there are certain factors, which seem to be likely.  Trauma or injury to the Achilles tendon itself is an obvious cause of subsequent tendonitis.  An altered gait, high heels over a long period of time or limb length discrepancy can also create excessive strain upon the Achilles tendon resulting in localized swelling and pain.  Over use, excessive training and improper stretching can also result in Achilles tendon injuries.  The bottom line though, in most cases of Achilles tendonitis, is the same…pain, reduced range of motion, localized swelling, and a potential long-term problem that is usually slow to respond to therapy.

In discussing the treatment approaches to an Achilles tendonitis, we must first mention the necessity of a thorough examination by a specialist.  Fractures of the heel bone, partial ruptures of the tendon itself, and localized soft tissue problems must all be carefully considered and ruled out.  The specific treatment of an Achilles tendonitis might include physical therapy, shoe padding (lifts to raise the heel), possible orthotics, oral anti-inflammatory medication, some form of immobilization, and reduced physical activity until the condition improves.  Surgery, although mentioned for completeness is rarely used.  It should be mentioned that this painful and often disabling condition, while frequently slow to respond, will usually improve and resolve with therapy over time.

Patients often find themselves in a “catch 22” where the tendon needs to be lengthened through a progressive stretching program but said program only aggravates the condition.  With careful diagnosis and addressing of symptoms, Dr. Sowell can determine the best way to proceed and hopefully return the patient to activity sooner than expected.