With the Kansas City Chiefs season off to a hot start, it feels appropriate to discuss a lower extremity injury well-known in the National Football League (NFL). Our own Eric Berry has dealt with this painful issue, which involves the Achilles tendon.
Achilles tendon injuries take on a variety of forms, which fall under the umbrella terms “traumatic” or “non-traumatic.” Traumatic translates to Achilles tendon rupture in most cases, but many people may experience non-traumatic Achilles pain caused by years of repetitive exercise. Achilles tendinosis is a common non-traumatic Achilles problem and is considered an overuse injury.
Running is the main cause of Achilles tendinosis, although it can occur in any sport. One is more likely to acquire it if one has postural problems such as flat feet or very high arches. Poor shoe quality also contributes, so it is important to buy new running shoes every 300 miles. A less common yet more serious contributing factor called “inflammatory arthropathies” may contribute. These include conditions like psoriatic arthritis, gout, rheumatoid arthritis, etc.
It is important to be evaluated by a foot and ankle specialist if you experience pain in the back of your heel consistent with Achilles injury. A podiatrist will be able to decipher between paratenonitis, insertional Achilles tendinosis, non-insertional Achilles tendinosis, retrocalcaneal bursitis, Haglund’s deformity, Achilles tendon tear, or the list goes on. As you can see, heel pain could be one of many different conditions (and sometimes even several conditions occurring together).
Depending on the pathology, your podiatrist can treat your heel pain using simple modifications to your training regimen, stretching protocol, NSAID medications, orthotics with a specially designed heel lift to decrease the tension on your Achilles tendon, among a variety of other treatments. Likewise, a benefit of going to a foot and ankle specialist like us at Jayhawk Foot and Ankle Clinic, is that we know which treatments to specifically avoid in this region. For example, steroid injections are commonly used for pain secondary to inflammation; however, steroid injections in the Achilles tendon are known to lead to Achilles ruptures and should be avoided.
Your doctor will work with you to find a treatment that is aggressive enough to treat the injury yet sensitive to your specific circumstance. For example, a high-end athlete may resort to surgical treatment to avoid losing function of the Achilles whereas an older patient may opt for minimal treatment to control the inflammation while modifying his or her activity level. Regardless, it is important to seek treatment before further degeneration of the tendon occurs, which ultimately can lead to rupture.