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Achilles Tendonitis Treatment in Los Angeles

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Man with stiffness, swelling, and inflammation in achilles tendon stretching

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What is Achilles Tendonitis?

Achilles tendonitis is inflammation of the Achilles tendon, which causes pain, stiffness, and swelling. It is often caused by overuse or repetitive strain. The Achilles tendon is a strong, thick, and important structure that functions to bring the ankle and foot downwards and propel the body forward in gait.

Thousands of fibrous bands of tissue bind together to form the dense Achilles. The calf muscle (gastrocnemius) becomes the Achilles tendon about midway in the lower leg. The tendon travels down the back of the leg, crosses the ankle, and attaches to the top and back of the heel bone (calcaneus). The Achilles tendon acts as a “rubber band” that stretches back and forth with each step.

When there is an acute or new injury to a portion of the tendon, and it becomes inflamed, this is called Achilles tendonitis (-itis = inflammation). In this acute state of injury, the swelling of the tendon is not visible.

A tendon is a fibrous connective tissue that attaches muscle to bone. Tendons cross joints in order to move the bone. One tendon is made up of hundreds of tendon fibers to make a cord-like structure that is flexible but inelastic and capable of withstanding significant tension.

Tendonitis is a type of tendinopathy, which is inflammation of a tendon. Chronic tendon injury is called Tendinosis. Tendonitis is usually caused by multiple micro tears in the tendon's substance. It can affect people of any age, but is more common among adults who play a lot of sports. Elderly individuals are also susceptible to tendonitis because tendons tend to lose their elasticity and become weaker with age.

Left untreated, Achilles tendonitis can transition into a chronic state called Achilles Tendinosis, where a thickening and swelling of the tendon is visible. This can eventually lead to partial tears and an Achilles Tendon Rupture.

Signs and Symptoms of Achilles Tendonitis

Achilles tendonitis presents as a deep, aching pain that can sometimes feel sharp, especially during walking or activity. The common symptoms of Achilles tendonitis include:

Deep, aching, or sharp pain, especially when first out of bed or prolonged sitting
Increased pain when walking or engaging in an activity
Pain when squeezing or applying pressure to the tendon
Stiffness and significant pain with the first steps after rest
Temporary relief with movement, but worsening pain by day's end
Increased discomfort when barefoot or wearing unsupportive shoes
Swelling, redness, warmth, or the presence of a lump near the tendon

Person in Los Angeles with achilles tendonitis showing deep aching pain, stiffness, and swelling

CAUSES

Causes of Achilles Tendonitis

Achilles tendonitis develops from repetitive stress, overuse, or sudden strain, often due to insufficient warm-ups or improper stretching. Micro tears occur near the tendon’s attachment to the heel, an area with limited blood flow, leading to inflammation and pain. This condition is common in both athletes and non-athletes and is often worse in the morning when the tendon is in a shortened state. Individuals with naturally short tendons or those who wear high heels or engage in activities like ballet are at higher risk. The most common causes of Achilles tendonitis include:

Repetitive overuse or sudden movements from a stationary position

Insufficient tendon flexibility, leading to micro-tears

Limited blood flow near the heel attachment, weakening the tendon

Increased stress on the tendon after prolonged rest, especially in the morning

Congenital short tendons or acquired shortening due to lifestyle factors

Wearing high heels regularly or performing activities like ballet dancing

Diagnosis of Achilles Tendonitis

Diagnosing Achilles tendonitis involves a comprehensive clinical evaluation and imaging studies. Dr. Soomekh utilizes the following methods:

Patient consultation: Discussing symptoms, concerns, and treatment goals
Hands-on examination: Assessing foot and ankle structure, Achilles tendon integrity, and gait patterns
Specialized tendon evaluation: Identifying any underlying causes or tendon shortening
Digital X-rays: Evaluating the heel bone for spurs (retrocalcaneal exostosis) and detecting calcifications within the tendon
Diagnostic state-of-the-art ultrasound: Assessing tendon thickness, swelling, and potential damage or tearing
MRI (if needed): Ordered for severe tendon tears, ruptures, or chronic Achilles tendinosis cases

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Los Angeles woman exploring non-surgical, conservative treatment options for achilles tendonitis with home-therapy

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Achilles Tendonitis Treatment Options

Conservative treatments rely on their ability to decrease pain, reduce inflammation, stop the micro-tearing of the tendon, and stretch the tendon. Surgery is not usually needed for acute Achilles tendonitis. However, with patients seeking treatment late or those who fail conservative therapies, Achilles tendonitis may have evolved into a chronic state, which is then called Achilles tendinosis.

Dr. Soomekh will recommend a strict two to four-week initial home therapy protocol. This includes:

Ice therapy and NSAIDs to reduce inflammation
A rest period to relieve strain on the tendon during healing
Proper footwear discussions to support the tendon
Heel lifts to create slack in the Achilles
Possible use of a walking boot for added stabilization
A stretching regimen for the calf and Achilles, particularly in the morning and after rest
Potential physical therapy visits for guided exercises

Custom Molded Orthotics

Custom molded orthotics (insoles) are an integral part of healing and maintaining the integrity of the Achilles and redirecting the pull of the tendon. The pull of the tendon on the heel bone plays an important role in the support of the arch of the foot. When the tendon is damaged and irritated, the arch and the heel will need to be supported by a custom orthotic to reduce the forces placed on the tendon while walking and during increased activity. The orthotics control the amount of motion through the heel during gait and take off some of the strain the tendon would normally incur.

Cortisone (Steroid) Injections

Dr. Soomekh does NOT recommend cortisone injections for Achilles tendonitis. Steroid injections have many positive applications for the treatment of foot and ankle problems. However, the Achilles tendon can weaken when injected with cortisone.

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‍Achilles Tendonitis

How to Get the Best Achilles Tendonitis Treatment in Los Angeles

At Foot and Ankle Specialty Group, we’re committed to helping you get fast, effective, and lasting relief from Achilles tendonitis. Our compassionate team, led by Dr. David J. Soomekh, the best Achilles tendonitis doctor in Los Angeles, will help restore function and mobility and get you moving again!

Whether you need conservative treatment, regenerative therapies like PRP, or advanced surgical solutions, we’re here to help in a warm, inviting, and compassionate environment. Contact us today to schedule your consultation.

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