A Monthly Foot Fact from Foot.com

Do you sometimes experience a burning pain above the heel with every step you take? If so, you might have achilles tendonitis, a condition that plagues athletes and non-athletes alike.
Achilles tendonitis is caused by inflammation and degeneration of the achilles tendon, the large tendon located in the back of the leg and inserted into the heel. This tendon can be aggravated by activities that repeatedly stress the area, such as running, jumping or other pounding sports, or can be injured by a single traumatic event.

Achilles tendonitis can also be caused by not stretching regularly before exercise or wearing high heels that cause the tendon to shrink and become more vulnerable to injury. In some cases a heel bone deformity, or even prolonged periods of standing, can cause symptoms. The pain sometimes lessens during activity.

According to Dr. Suzanne Belyea, D.P.M., Medical Director of Foot.com, symptoms of achilles tendonitis include a shooting or burning pain, or an extremely piercing pain. “The pain will be in the area in the back of the heel, and can also be perceived as tenderness upon rising first thing in the morning or after sitting for an extended period of time. If the condition is aggravated by a shoe rubbing against the tendon, you might see redness and feel soreness to the touch.”

Dr. Belyea notes that several factors can contribute to the onset of achilles tendonitis. The most common is over-pronation, or flat feet, which occurs when the arch of the foot collapses upon weight bearing, putting stress on the achilles tendon.
Improper shoe selection can also lead to the condition, or aggravate it.

“Choosing your footwear is important if you are suffering from achilles tendonitis,” Dr. Belyea says. “You want to look for a good, supportive athletic shoe that has an ‘achilles notch’ to reduce rubbing and irritation in the area.”

Achilles tendonitis is often experienced by athletes, particularly distance runners. But it is difficult to treat in athletes because of their high level of activity and reluctance to stop or slow down their training.

The condition should not be left untreated, however, because the tendon can become weaker and eventually rupture, causing a serious injury that is much more difficult to treat. Statistics show that men between the ages of 35-50 have an increased likelihood of rupturing the achilles tendon because they tend to be “weekend warriors,” exercising on weekends without proper preparation or stretching on a regular basis.
Athletes, particularly runners, with achilles tendonitis should stretch carefully to warm up the muscles before exercise. They should decrease the distance of their walk or run, apply ice after the activity and avoid any uphill climbs.

If over-pronation is the source of the problem, a ready-made posted orthotic can be used to correct it. In many cases, a heel cup or heel cradle will help by elevating the heel to reduce stress and pressure on the achilles tendon. These devices should be made with light-weight, shock absorbing materials.
Dr. Belyea notes that if achilles tendonitis is treated properly and the correct orthotic is used for the specific biomechanical problem being experienced by the patient, relief should be possible in one to two weeks.

If the problem persists, consult your foot doctor. For more information on achilles tendonitis and other foot conditions, visit www.foot.com. Foot.com is dedicated to educating the public about foot health, creating forums for consumers to communicate with foot health professionals, and most importantly, eliminating unnecessary foot pain.