Achilles Tendonitis Treatment Process

TREATMENT PROCESS

This is my current treatment process for patients with Achilles tendonitis, please watch the video for full details. 

I find that patients who track their activity get better faster. Here is an app that I helped develop to track your progress and actions.

Scan this QR code or click HERE to learn more. (iPhone only for now)

• 1st Visit - Evaluate your condition, review x-rays, and perform a walking evaluation to determine the cause of your condition. Start working to reduce inflammation, reduce tightness and reduce stress through your Achilles tendon. 
• 2nd Visit - Will evaluate the initial treatments and if indicated perform an ultrasound examination to evaluate the thickness of the Achilles tendon to help guide further treatments.  
• Shockwave and Amnio Injection - Most of my patients benefit from a series of 3-6 sessions of shockwave therapy to improve blood flow and recovery of the Achilles tendon. After these sessions then patients go through a course of 6 weeks of physical therapy. At times to help speed up the healing an Amniotic injection is beneficial. 
• Orthotics - Orthotics are useful to stabilize the heel position, help with posture and reduce excess movement of the foot that can increase stress in the area of the Achilles tendon. 
• Physical Therapy - After these sessions of shockwave then patients go through a course of 6 weeks of physical therapy. 

• Daily Rituals: These are the daily rituals that can be used with other office-based treatments. Towel stretch before getting out of bed (30-second stretch 3 times), foam rolling (10 minutes 2x a day), icing or contrast baths (10 minutes 2x a day), anti-inflammatory for 2 weeks at a therapeutic dose (if not doing shockwave), stable shoes and orthotics, Oofos sandals in the house, and avoid going barefoot. Wear shoes that have a slight heel and avoid incline walking and activities that aggravate your Achilles tendon. 

• Cortisone Injection - Rarely is this indicated in the Achilles tendon due to concern of weakening of the tendon. 
• Brace - At times I recommend an off-loading brace to reduce pressure on the plantar fascia and move the pressure to the lower leg region. 

COMMON QUESTIONS

• What if my night splint is painful or causes numbness? Start with taking out a wedge in the device or reduce the tension of the device. If is not getting better please call or send me a message so I can help. 

RESOURCES 

• Shockwave (EPAT) - Information about shockwave therapy.

• Orthotics -  Explanation of how and why orthotics help foot pain.

• Icing and Contrast Bath Instructions - Here is information on how to ice your foot. 

• Oofos - Recovery sandals to wear at home for more support.

• Shoe Recommendations - Here is my shoe recommendation.

• Foam Rolling Exercises - Instructional video for foam rolling. 

• Eccentric Exercises - Exercises to help with strengthening your foot. 

• Aerospring Brace - This is a carbon fiber brace that can offload the plantar fascia. 

PRODUCTS 

Here are some of the best recommendations I have found on Amazon to start treatment before you come into the office.