2021 was a crazy year for injuries, as Sydney lockdowns forced people to abruptly change their activity and exercise routines. More people have taken up running than ever before, and as a result we’ve seen more heel pain cases than ever before! Thankfully we’ve been able to help manage many injuries and assist people in getting back on their feet pain free. Today I’ll share one particular success story we had recently for a male patient suffering with a significant case of insertional achilles pain.
John first came to us at the end of February with debilitating heel pain – right at the insertion of the achilles tendon onto the heel bone. This pain had been present since October last year, almost five months in total! This is his first time experiencing insertional achilles pain and unfortunately has remained consistently tender to touch. John has tried a number of treatments including acupuncture, stretching and icing, but the symptoms have only worsened with time. He hasn’t been able to enjoy his social coastal walks for quite a while, so the time has come to get his insertional achilles managed!
Why did the achilles first become painful?Upon taking a thorough exercise history of John, it was clear the achilles insertion first became symptomatic in October last year – near the end Sydney’s Covid lockdown period. John was walking more than ever before during lockdown: 10km walks 4 to 5 times per week. That’s almost 50km each week! Given the significant increase in walking during lockdown, the achilles tendon was placed under higher stress that it wasn’t capable of handling.
Treatment plan for a painful insertional achillesAfter conducting a biomechanical assessment of John’s feet, we have a clear diagnosis of his heel pain and an understanding of why it may have occurred. We were able to put together a treatment plan tailored to John’s needs.
The plan will be focused on three areas:
- Managing symptoms
- Offloading the heel
- Shockwave therapy: to help release surrounding soft tissue, increase blood flow and provide short term pain relief.
- Heel raise inserts to offload the achilles: These will lift the heel up and shorten the achilles tendon, not allowing it to stretch as much while walking around.
- Specific strengthening and stretching exercises: To increase the resilience of the achilles to be able to handle longer walks.
- Footwear advice: Assuring John had adequate supportive footwear to keep his heel stable
- Activity education: Guiding John through the process of getting back into his walking without exacerbating the heel.