Achilles Tendonitis

Achilles Tendonitis Specialist
For New York City patients dealing with Achilles tendonitis, doctors at Gotham Footcare can help. Miguel Cunha, DPM, and the team of phycisians can work with patients to determine the underlying cause of the discomfort and craft a personalized treatment plan. Patients can visit the two convenient locations in Midtown and Downtown Manhattan, New York.

Achilles Tendonitis Q & A

What is Achilles Tendonitis?

Achilles tendonitis is inflammation along the Achilles tendon. The Achilles tendon is the largest tendon in the body and is, therefore, susceptible to overuse injuries from running and jumping type exercises. It is responsible for plantarflexion of the ankle (causing the front of the foot to lower and lift the heel off the ground).

What causes Achilles Tendonitis?

Achilles Tendonitis is usually due to excessive repetitive stress to the tendon. Typically, this condition is not related to a specific injury but rather due to over exertion of the Achilles tendon in specific situations including:

  • Increasing the amount or intensity of physical activity too quickly
  • Wearing high heels (which can place stress on the tendon)
  • Having tight calf muscles
  • Running on hard surfaces such as concrete
  • Frequent jumping activities (such as in volleyball, basketball, dancing, football, baseball, tennis)
  • Using shoes with improper support
  • Formation of a bone spur-Extra bone growth where the Achilles tendon attaches to the heel bone which can rub against the tendon and cause pain.

What are the symptoms of Achilles Tendonitis?

  • A burning pain or stiffness along the lower leg above the heel in the morning especially when stretching your ankle or standing on your toes
  • Pain along the tendon or back of the heel that worsens with activity
  • Severe pain or swelling the day after exercising
  • Thickening of the tendon
  • Bone spur

How is Achilles Tendonitis diagnosed?

At Gotham Footcare, your doctor will conduct a thorough physical exam of your foot and ankle. Your doctor will determine the location of your pain, tenderness or swelling, and evaluate the flexibility, alignment, range of motion, and reflexes of your foot and ankle.

Your doctor may order one or more of the following tests to assess your condition:
X-rays. Our in-office digital X-ray system will provide your doctor with clear images of your foot bones. Radiographic evaluation can demonstrate whether the lower part of your Achilles tendon has calcified, or become hardened, indicating insertional Achilles tendinitis.

Ultrasound: This in-office device uses sound waves to visualize soft tissues like tendons. Ultrasound can also produce real-time images of the Achilles tendon in motion, which may allow for visualization of inter-tendinous tearing and inflammation of the tendon.

Magnetic resonance imaging (MRI): An MRI may be prescribed if further evaluation is warranted. An MRI uses radio waves and a very strong magnet to produce more detailed images of the Achilles tendon.

What is the treatment for Achilles Tendonitis?

Most cases of Achilles Tendonitis can be treated conservatively with nonsurgical treatments, although it may take several months for symptoms to completely subside. This involves a number of modalities including:

  • Resting: The first step in reducing pain is to decrease the activities that aggravate one’s symptoms. Switching to low-impact activities until the acute inflammatory phase has passed will put less stress on the Achilles tendon.
  • Cross-training activities such as biking, elliptical exercise, and swimming are low-impact options to help you maintain being active.
    Icing. This can be done up to twenty minutes interval through the day as necessary.
  • Stretching exercises
  • Strengthening exercises with eccentric contractions of the Achilles.
  • Supportive shoes and Heel lifts
  • Custom-made orthotic devices, which are made at Gotham Footcare using a state of the art laser scanner.
  • Non-steroidal anti-inflammatory medications (NSAIDs): Drugs such as ibuprofen and naproxen reduce pain and swelling.
  • Physical therapy: At Gotham Footcare physical therapy modalities such as electrical stimulation, ultrasound, hydrotherapy, and shock-wave therapy will be administered to the Achilles tendon. These modalities are very effective in treating Achilles Tendonitis.

What happens if conservative treatment fails?

Gotham Footcare prides itself on offering the latest minimally invasive surgical treatments. Two of the latest and most effective surgical management techniques are Tenex and Platelet Rich Plasma (PRP) or Amniotic Injections.

Platelet Rich Plasma PRP is derived from a patient’s own blood, which has been processed to concentrate the platelets. These concentrated platelets contain powerful growth factors that can jumpstart the healing of injured tendons and ligaments by stimulating tissue repair and regeneration. This procedure is done in conjunction with Tenex to maximize healing and repair of the Achilles Tendon.

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