Top Tips for Insertional Achilles Tendinopathy
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- Опубликовано: 25 июл 2024
- In this video, Maryke discusses why you can't treat an insertional Achilles tendinopathy in the same way as a mid-portion one and gives some tips on how to settle the acute pain during the first few weeks.
👉 Heel wedges (use them in both shoes) can help to relieve the pressure on the painful part of your Achilles tendon: geni.us/lA7G
🌟Need more help with your injury? You’re welcome to consult one of the team at TMA online via video call for an assessment of your Achilles injury and a tailored treatment plan: www.treatmyachilles.com
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👉 Heel wedges (use them in both shoes) can help to relieve the pressure on the painful part of your Achilles tendon: geni.us/lA7G
If you buy anything via this link, we may get a small commission at no extra cost to you.
Thank you very much hopefull we will use the links to buy something at least to help you a bit Would you please and kindly tell if walking with sabots/clogs/crocks is ok (to avoid irritation namely with haglund and burstitis and insertional tendinopathy which heel inserts or insoles shall we use ?? Would you like to put links for normal foot type ?
Thanks a lot for this video and other ones. They are very helpful. I'm pissed off to see how well paid (by me unfortunately) doctors and physio suggested wrong exercise and cannot understand patient feeling/needs and let me say also the PAIN. Nowadays, you need to be a physio expert to control a normal physio "expert". I'm grateful that you are online and explain us all. Thanks for it.
Brilliantly explained, makes heaps of sense, thanks so much 😊❤️
Thanks so much for the diagnosis! It’s exactly what I have.
Glad you found it useful!
Oh, this pinpoints my symptoms. Thanks for making this video and how to heal this type of tendinopathy.
Absolutely very clear and very helpful- thank you
You are great! Thank you so much for your videos. This is finally it after a couple of doctors who said that I am already too old so it is ok to have my feet hurt (I am 41) and another one who told me to do those stretches that absolutely made my problem worse. Even if I told them I have pain in the back of my heel bone they would prescribe me exercises against plantar fasciitis. I figured a shoe thing myself already, were adding massages and work with my foot stability, and now this. Thank you again.
Your explanation is so easy to understand and logical. Many thanks.
You are welcome!
Great information, thank you.
Thank you for this specific, detailed explanation. I now feel well-informed about how to correctly plan my recovery efforts.
You're welcome!
Was doing the wrong heels down for almost two months and after watching your video stopped it 3 weeks feeling much much better thanks a lot
A doctor actually told me to do heel drops! So happy that I went home and did some research!!!
@@jennifermosley2387 my doctor told me any stretching of which remains the feet to 90 degrees . Thnx for the input
For anyone early on in your insertional achilles injury - sharing my experience.
My first 3 months - I avoided dorsiflexion basically as much as possible. Calf raises / heel drops all done from the floor, always.
By month 4 - I was feeling like I was really coming along well and nearing fully healed. I had not been adding heavy weight to my calf raises, yet. But at this point my tendon was at least accepting of the forces I was putting it under from walking. Walking daily, for exercise, 2.5 miles a day Monday-Friday. On the weekends I would sometimes walk 2.5 miles again, but sometimes more - maybe 4-5.
I began to mix in 30-60 second jogs to my walks. After about 2 or 3 days, I re-aggravated my heal / tendon. I realized foolishly it was because I hadn't been loading it incrementally with weight while doing calf raises.
After resting it for a few days - and getting 0 improvement. I grabbed a 30lb kettle bell weight and through it into a backpack. I did 3 sets of calf raises, from the floor.. with the added weight. While doing this I was also near my fireplace at home that has a shelf on the wall. I added even more resistance by pushing my hands up into the bottom of the shelf basically putting even more force on to my tendon.. with the added weight and my resistance it was about an additional 50lbs of weight beyond my body weight.
After doing this every day, twice a day... for about 5 days - my flare up pain disappeared almost entirely.
I continued on for another week of this, getting better and better. Now for the last four days - I am now doing calf raises / drops with added weight off a step.. and it's no longer causing my heel / achilles to flare up like it would early on.
So my advice - and your experience may differ.. You eventually may find yourself stuck, not advancing after a few months of being conservative. Adding that extra weight is definitely the answer to getting to the next "phase" of recovery. Theres going to be pain and setbacks. But I promise you, sitting around resting or trying the same things over and over isn't going to work. My PT finally pushed me to move forward. And its working.
I've spent months wondering when I could dorsiflex again. The answer is - you'll know when its time. It takes a while to get there. And for me, it was 4 months.
I plan to continue and gradually add more and more weight to my raises over the coming weeks. There will be some pain.. but, it doesn't mean you're starting back on day 1 again. Good luck.
Ended up back at square one. The dorsiflexion began to give me problems after a few weeks.
I ended up getting an MRI. Confirmed retrocalcaneal bursitis. The calf raises were causing me to get worse and worse.
Here I am a month later. In complete agony. No longer able to wear closed back shoes. Unable to walk.
Now that I know my exact diagnosis I am basically sitting on my ass. Popping the maximum amount of NSAIDs possible. Using Voltaren gel on my heel / ankle. Icing it 4 to 5 times a day. (Icing it now as I type this.)
Not sure where to go from here. Well see if I end up needing surgery. My MRI didn't show any bone spurs, but it did detect an Os Trigonum present. Discussing with my doctor next week to hear if they think its involved or not. 7 months of agony. Get an MRI people. If you're still in pain after 2 to 3 months.. just do it. Its not fun throwing darts at maybe rehabbing the right thing. I've dedicated nearly an entire year of my life being in horrible pain and its... pretty much ruining my life.
@@xbadandy182x How’s the recovery? Been dealing with this for over a month now. Seeing a podiatrist next week but wondering if I should see orthopedist instead. Or PT. Are you able to see a bump or swelling?
@@adimperial Recovery has been rough. Don't let my story bring you down, first off.
When I initially hurt myself, it was a slight twinge on the side of my heel - on the inside of my foot (medial).
Around the time I made this comment, the pain had settled and moved more into what felt like the achilles (insertional) area. Dorsiflexion made my heel pain flare up at that time.
Between heel lifts, orthotics, and strengthening the area with raises it got better and progressively improved.
Fast forward to June 28th - a couple months ago - my foot started to stiffen up and hurt again. This time the pain has shifted to the lateral side of my heel.
I had an MRI done. I have a fairly large ganglion cyst deep in my ankle joint. I also have some fluid and swelling in my peroneal tendon which again is the outside (lateral).
I had a steroid injection into my peroneal tendon sheath 2 weeks ago to see how much of my pain improves, if any.
On Sept 20th - I will be getting a lidocaine injection in to the cyst, again, to see how much my pain relief improves.. if any.
I am at a point where I need to make a decision about surgery. I've done it all and the foot continues to plague me. The movement of my pain, and all of the tissues involved really makes me THINK this cyst has been my real problem all along. I've been "diagnosed " with insertional achilles tendonitis, retrocalcaneal bursitis, peroneal tendonosis, and now I'm having some swelling over the top of my ankle specifically the extensor digitorum brevis area.
I haven't run since January. I haven't exercised (walk / bike / elliptical) since June 28th. Yet - even doing P/T, dry needling, foam rolling, icing, stretching, elevating, compressing, NSAIDs, the steroid injection... the pain won't go away. I find it really hard to believe I could have given myself all of these "overuse" injuries when I've been taking it easy for basically 9 months now.
So long of the short. I may be getting surgery to get the cyst removed. Or, debridement on my peroneal tendon. Or - both. All depends on how this lidocaine injection goes.
The MRI is really what has helped make sense of this problem im having. Unfortunately I'm still doing what the doctor says to isolate whats actually giving me pain.
@@adimperial To address your question directly. It all depends on what variation of tendonitis / tendonosis you think you might have. I think early on - the first month its best to de-load and do everything to just make it stop hurting.
Ice packs on the heel. NSAIDs. Voltaren Gel. Heel lifts. Shoes that don't bother you. (I wore Hoka recovery sandals around the house with heel lifts set on them around the house for a couple months just to support my foot and prevent any chance of a shoe rubbing on my heel)
Once the pain calms down start with isometric holds from the floor, and eccentric calf raises from the floor. I was doing that for 3-4 months, adding weight gradually before I moved to doing calf raises from a step for full range of motion.
These injuries take forever to recover from especially if you're older (I'm 37).
@@xbadandy182x Can you give another update on your injury journey? How would you assess the advice in the video looking back?
I have this on both sides and plantar fasciitis, both sides. I've had to drop shifts over the years because of the pain, full time to barely part time.
My sympathy to anyone experiencing the same pain!
Thank you for your videos, super helpful!
I have almost the same... plantar fasciitis on both feet for 3 years and achilles tendonitis only on the left side since about a month. Has anything changed for you in the past 3 months? Any exercises/things you did that worked? Any ideas what's causing all of these foot problems?
@@kite4804i have it to ,1 foot is totaly healed iv been doing calf raises with dumbells every 48hours,also working abs glutes hamstrings and quads because all muscles got weak from bot walking for months,now i have only 1 foot to recovery,is the one that is more chronic i have it almost for 3 years but i have improved alot, my problem was taking advice on stupid doctors giving me nsaids and corticoids and no loading execises and only doing stretching i was just agravating the situation
Good info for my problem! I was doing exactly the wrong thing for a bout a week. For the average person, about how long before starting calf and Achilles stretching? I have no pain with walking or at rest luckily, only with the stretching I shouldn’t have been doing. Pain very focused at the back of leg and plantar surface of heel angle. A thin line of pain you could say, just at the edge of the heel!
Thanks this is really helpful. I wondered if Birkenstocks could work and give enough of a raised heel?
Thank you very much-needed.
You're very welcome
Thanks for the tips. I have been suffering from this for some time as a result of running. Its an annoying painful injury
I found my solution. I’ve been wearing a boot for two weeks and it helped but only a little, as well as strengthening. Two days ago I relentlessly used a massage gun and lacrosse ball on my calf muscle on my injured side. My heel pain pretty much magically disappeared immediately after. Probably not the solution for most people, but it helped me immensely. I’m guess my tight and injured calf muscle was creating a lot of tension and causing the insertion point to be very irritated.
Yes, this is my pain. trying to read comments here that would really help me with my self-rehab. Thank you.
Good luck with your recovery!
Thanks for the vedio, I tried almost all the excercises that was recommended in other RUclips channels but l the pain was not getting reduced. Your vedio helped me to recover but still I expirence some pain when I press. I have been a barefoot runner since 5 to 6 years. stopped running and heel stretching since 3 weeks and I m doing better. Thank you once again:)
How Are You now?
I've been doing it all wrong!!! I'm so glad I found this video. I work as a bellman/valet parker and I'm a 100% sure I have this issue. I thought stretching it out would help and what you said makes sense. I'm going to buy some heel inserts today and hopefully it helps. Thanks for making this video.
Glad you found it useful! Getting your shoes + inserts right will likely make a huge difference if you're on your feet a lot.
heyy
R u Ok now???
Or Still suffering????
Please reply🥺🥺
Thank you so much, I have suffered with insertional tendonitis probably from years of Skateboarding! You are a life saver with the advice on NOT! streching the calf in the early stages of inflamation and injury, and not walking round flat shoes or bare feet. I have struggled for a week now as I thought it was better then decided to walk to work invloving a steep hill and felt or heard a faint click or pop in my heal and carried on then the next morning Boom! it was back with a vengence! swollen, red and sore to the touch! So now, Patience and your advice is giving me hope that in a few weeks it will have settled then maybe I will start cycling to build up strenght. Thank you 🙂😇😇😇😇😇
You're very welcome and best wishes for your recovery.
Marvelous, thank you
Good video, Covid helped mess up my Achilles. Nothing but zoom meetings for 6 months and the occasional day at the office then suddenly 8 hours a day standing at work and around 8kms a day of walking. Sudden achilles agony. Trying to take some painkillers and ice it up a bit to help. Maybe slightly better now a week after it began but hoping it might be good enough to walk on without stabbing pain in a couple of weeks.
Try finding a shoe with a heel that is comfortable to off-load it.
Thank you for the vedio. I have insertial tendonities for 1 and half year but no doctors or physio is able to understand my pain. Please let me know the excercise for this
Thanks for the video its sounds like what i have been a long distance lorry driver for 20 years
How interesting - yes, I can see how driving for so many hours can predispose you to this.
I feel like this is what caused mine too! I am always driving around in my work van from job to job sometimes for an extended period. I remember this first onset for me last year when I came back from a 2hr drive home. Now it constantly bothers me right at the heel, and say I jump off something a few feet high and land, it can aggravate the heel so bad that I walk with a limp for a week or 2
Great video. Do Powerstep Protech insoles or Tulis green heel cups help for this condition? If so, is one better than the other?
I have chronic Achilles Tendinopathy and tried literally everything and nothing gave me much relief.
I came up with a little stretch which got rid of my pain overnight.
I placed my achilles between my big toe and second toe on the opposing foot and gently push down the heel and stretch everything.
I did this about ten times and followed it up with massage working downwards around the back of the heel.
Finally something that works!
Give it a go it worked for me.
Explain more? This may work for me but don’t really understand
Kindly make a video, pain is bad. Many people will pray for you. Help please
I've tried that a lot, didn't make a noticeable difference. Glad it worked for you. That's the thing about this condition - everyone seems to have slightly different symptoms, with different things that seem to help. Hard to find what those things are for any given case - just gotta keep looking :)
@@destructionman1 Yes it's been a year since this comment and I agree it doesn't do that much.
I can only tell you what I've learned since then and I hope it will help you.
I now wear nothing but Hoka Stinson shoes as they eliminate me heel striking on that part of the tendon or Oofos thongs for around the house are good too. These or some other shoe that gives you that thick cushioning.
After a day on my feet before bed I use a massage gun on the back and sides of the heel. (It seems to promote circulation and healing overnight and I feel better in the morning) I do the massage manually as well and those same little stretches.
Lots and lots of calf raisers. I've built up to doing about 400 a day. For the first few months I wouldn't drop below horizontal until strength is increased and then gradually drop down to full range of motion. It seems to build up resilience in the tendons and they're less likely to get those micro tears that cause us to limp from walking around.
I don't think there is a cure for this horrible condition but you really can manage it well.
I'm probably 60% to 70% better now.
Just have to smile . be patient. I started road cycling. Easy 2 weeks . really helps keeping your conditioning in check lol
Thank you for advice will try this nothing works yet. I will try this and cone back here
Best of luck!
Thank you. You helped me too much
You're welcome!
Wow. Recurrent insertional tendonitis for over a year due to incorrect rehab strategy. Kept thinking I wasn’t doing enough heel drops and calf stretches.
I was doing them too early and too often and setting myself up for flare ups! This video is a game changer. Thanks!
yup this happened to me too
Same here!!
@@lameasstv1140R u Ok now??
Or still suffering🥺🥺
Hi, when you say flare ups -- what kind of flare up were you experiencing ? Pls do let us know.
Thanks.
this is awesome, you are doing a great service! question - does icing help with initial swelling related to insertional achilles tendinopathy?
It helps with pain and a bit with swelling but it doesn’t improve healing. So use it if you need it for pain but no need to use as routine treatment.
So what do I for exercise in the beginning step? Isometric heel raise for the floor?
Great information. I just injured my heel and my foot doctor says I have a partial tear in my achilles tendon. She wanted for me to use a walking boot with wedges which irritated my heel so now she wants me to cast it instead and no weight on it. What do you think? I am still debating about it.
You do need a period where your foot is in more plantar flexion. The boot usually allows quicker mobility afterwards but the cast works just fine as well. Best to discuss it with your doc as she knows all the details about your specific situation xm
Could going from a 10mm drop trail running shoe to 4mm drop cause more stress on the achilles? Do night splints with minimal pressure on foot help with recovery ?Thank you! Love your videos!
I'm no doctor, but I would think that would not be good. That's more than a 50% decrease in heel drop. I was told to wear shoes with a MINIMUM heel drop of 10mm, with Achilles Tendonitis. I wear a 12mm heel drop shoe and add heel lifts on top of that! My shoes are New Balance 993 and I add Powerstep Pinnacle Maxx insoles that have a heel post. 4mm shoes are not good for those of us with AT, according to what the podiatrist and PT told me. Good luck to you!
Hi, thank you so much for your video I am a professional ballet dancer and that’s exactly what I have. Lot’s of physiotherapist have told me to stretch it but it got worst. It’s been three months now that I can’t jump. Finally I think that I might figure out why it didn’t work. I tried shockwaves but the pain isn’t completely gone. What can I do to strength it? Do you recommend wearing point shoes ? Thanks
What are "shockwaves"?
hi there is it possible to have both? i feel pain higher and lower where it attaches
Any advice for those with haglunds?
I have noticed that show with a snug heel cup make it hurt almost immediately. Is that common?
Hi great stuff. What about leg workouts like squats, deadlifts, leg extension, curls?
They are very good to include for the rest of the body - you just have to make sure you avoid stretching the Achilles while performing the squat especially in early stages - placing books under your heels so you do squats with heels lifted can help.
Here's some more advice on squats ruclips.net/video/gi-tvosxA8g/видео.html
Thanks 👍🏻☀
You’re welcome 😊
Thanks for that, I will stop using the stair stretches immediately that I was told to do. Should I stop doing lunges as well though?
If you are unsure about how lunges affect your tendon, stop them for a week to allow it to calm down and then add them back in and see how your pain responds in the 24 hours after doing them. If it increases, then it is likely best to stop the lunges for now as well.
Have been watching your videos for a while now, so I am wondering what you think about radial shockwave therapy which I have started to have on my Achilles? Would you recommend it? It initially worked straight after and I could walk without limping but until I go back next week I have days where it's ok and then it's painful?
It can be really useful for insertional tendinopathy, but it often takes about 4 sessions for good results. What you do between and after sessions is important - so you should take care what shoes you wear and follow the rehab advice so you don't irritate it unnecessarily.
How does your suggestion prevent development of scar tissue? Thanks!
Achilles tendinopathy do not form scar tissue. I know a lot of clinicians bang on about scar tissue in the tendon and that you have to break it down, but this is nonsense. The research shows that the tendon structure changes - it doesn’t for scar tissue. It is only if you tear the tendon that you get scar tissue. Maryke explains what happens in a tendon when you have a tendinopathy in this video: ruclips.net/video/nAUrK0lRC6A/видео.html
But what exercises do you recommend for insertional Achilles tendinitis??? I want to strengthen my Achilles but you mentioned many exercises not to do. What ca we do? Thanks
isometric holds and reduced range heel raises (from the floor not off a step)
I have been carrying an insertional Achilles injury for over 6 years now. The pain never goes away. To add to my pain, last year I partially thorn my achilles, the recovery has been really slow. Can you suggest different alternatives. At this point I know I will never be able to have 100% recovery, but I will like some improvement.
Carlos it would be much better if you actually consulted someone who can make you do test movements and take a full history of what aggravates your symptoms etc. and then use that information to design a rehab plan otherwise if you do things that isn't right for you it can either make it worse or have absolutely no effect.
Hi.
I am a track sprinter and I have been dealing with ins. achilles tendinopathy for more than a year. Started the first 3-4 months with stretching and calf drops and pain just would not stop. Then I changed to isotonic and eccentric exercices from floor along with calf raises with incremental loading. I am at a stage where I can run at 90% on a given day but can't to anything for the next 3-4 days because of pain.
Should I start with calf stretch and heel drops or still early ?
The problem is we use track spikes for training.
Thanks
She says calf stretch and heel drops are the worst thing you can do. Stop doing them lol. You don't want to have the tendon pull aggressively and put compression on the heel.
I've been dealing with this for some 10 years now. I have tendon calcification at the insertion en bone spurs on the calcaneus, on both sides. About once a year it all flares up resulting in limping and stiffness. Shockwave therapy combined with rest, followed by tendon strengthening exercises worked everytime for a while. But the periodes between flare ups are getting shorter and I can't bring myself to go through yet another 4 months of rehab just to have to do it all over again after just 3 trainingsessions on the rugby pitch. Orhtopedic surgery has always been a last resort and I seem to have reached that point now.
Will you have the surgery?
Is it ok if apply bandage or wear brace because I feel comfortable when use them.
Yes, absolutely but that should always be a temporary solution. Make sure that you also get it assessed and start a treatment plan to help it recover.
I have a little calcification on my insertional zone in the right achilles tendon.. Question: can i do full range hell drops for the left tendon and partial range drops for the right one? could this pratice cause some kind of unbalanced behaviour for my legs?
We have the same problem.. this type of injury is recurring.. I cannot run, jump and do backpeddling .. Bio mechanics needed for the sport of basketball. At least I can still walk.
Starting week 5 of rehab from insertional achilles tendonitis here. I am starting to see some improvement.
No more flare ups from just normal activity - walking, walking up/down stairs, etc.
The first 3 weeks I was on Holiday so I took it easy, taking NSAIDs to help with pain. By week 3 I was in a heel lift (Should have done that immediately). While using a heel lift, also avoiding walking bare foot. Began doing calf raises at this point - both legs / single leg / as well as bent knee / straight knee.
Last week, I ramped it way up. Doing isometric holds on each leg to warm up, then I go into 3x sets of 15 both straight and bent knee doing calf raises / single leg calf raises / single leg heel drop from the floor.
The other key has been avoiding dorsiflexion at all costs if possible. If I do heel drops from a step at this stage, it brings on heel pain. That pain at this stage is much improved from a few weeks ago when I tested response for dorsiflexion.
Its also worth noting the above calf raises I am doing them 3 times a day. So when its all said in done, at this point, I am doing over 800 reps of calf raises / heel drops per day. My 2nd session of the day i began using a backpack with 30+ lbs of weight to increase load.
Not fully healed yet but FINALLY can confirm improvement. Will continue again this week. And again after. I am feeling hopeful another month of this is going to see major improvement.
I'm going through the same thing. I do heavy loaded calf raises/seated calve raises but I never allow my heel to go below my toe. When I tried a dorsiflex stretch just stretching it seem to help. I felt a immediate release. Thx for sharing
Where can I find a tutorial or link to the calf raises? Glad your condition is improving!
@@SonofGod_7 Unfortunately no. After getting an MRI, it was determined I had retrocalcaneal bursitis as well as peroneal tendonitis. My bursitis is now healed after a month of rest, ice, heel lifts, and pain pills.
My peroneal tendonitis is still giving me problems and there is a good chance I am facing surgery. I have been injured for over 13 months.
Do you treat clients who have tendon damage as a result of taking a floxacin antibiotic such as Ciprofloxacin or levofloxacin? I took levofloxacin for ten days along with an oral steroid dec 2017 for sinus infection and have had L Achilles pain ever since intermittently until about six months ago when it became constant. I’ve tried to handle on my own with alternating ice and heat, stretching my calf & hamstrings, trying to ignore. I was working up until April this year at a job where I was on my feet 8-10 hours a day but I’m not working now as I lost my job due to covid 19 cut backs, so I thought more rest would help but it hasn’t. I’m not totally immobile though. Sometimes I’m sitting watching tv or crocheting, I’m busy around the house with laundry or running errands and I walk our dog almost every day about a mile to mile and a half around the neighborhood. I did have a Haglund’s deformity repair in aug 2016 and my Achilles was damaged some but not torn completely. I recovered from that surgery within six months and had no complaints until taking the levofloxacin. I plan on seeing a medical professional soon as the pain and swelling is constant, even laying in bed with my heel down on the bed causes pain so I try to sleep on my side. I do wear zero drop shoes as I prefer the flat, more minimal sole and got rid of all my other shoes with an elevated heel. I wear slippers in the house but was thinking I could get a pair of shoes with a slightly raised heel to see if that would help. What is your opinion on magnesium supplementation as part of treatment for Achilles insertional tendinopathy? There are so many conflicting opinions on the internet. I’m even nervous to go see medical professional. I’m 61 and not an athlete but I’m not a couch potato either.
Hi Brenda, yes we do help people who have sustained this through taking antibiotics and we have quite a few people who we're helping who aren't athletes either. Getting a shoe with a heel may be a good idea or even just buying some cheap heel lifts from amazon to put in your regular shoes can already help to offload your tendon and make it less tender. Have a look at our website if you would like to know more about the treatment options that we offer: www.treatmyachilles.com/treatment-packages
Hi thank you for this video. It was pleasant and informative. I have a question. I’ve been dealing with this dang thing for 6 months now and it’s gotten maybe 10% better. The ortho doc sent me to PT for 6 weeks and that had minimal effect. When I went back to the ortho doc for a check up, he put me in a walking boot for 6 weeks.
When I went to pick the walking boot up from down the hall, the doc who fits you for the walking boot said PT doesn’t work. I was baffled as to why someone in the same office as the PTs felt that PT doesn’t work? So now I don’t know what to believe and I’m still hurting. We did an MRI and everything looks decent. It’s just on this little bone spur where the tendon attaches is where it’s painful. Do you guys think a walking boot is a good suggestion? I know you said a heel insert (I bought some brooks and inserts), but what about a walking boot to completely immobilize me? I really don’t want to have to have surgery. Thanks for all your information.
Good day sir/ma'am
i think i have issue like yours, just want to ask how are your recovery now?
my 1st doctor told me i have a little spur same like yours and advice me have a physical therapy for two weeks, so i did it, after that PT it did not improve and thats the time the doctor told me to have a surgery..
i decided to get a 2nd opinion and the second doctor told me i don't have to get surgery cuz it will heal naturally..now the problem is i don't know what to believe and what to decide..
so just checking about yours what you did with your foot?
@@kimwarren7865 I have exact same issue as you. The two doctors I saw seemed unconcerned about any damage to my Achilles tendon even though that's where the spur and the pain are -- and they did not order an ultrasound to find out if the tendon is damaged. I'm pretty fed up with these "professionals" who don't seem to care and tell me no more than I've already learned through researching IAT for myself! I got a lot more information and help from RUclips. Next I will see another podiatrist and just flat out tell him I want an ultrasound.
@@kimwarren7865 My gosh, I am having the exact same experience that both you and Studio D are. I too have seen 2 different doctors and received conflicting advice. I too have a small bone spur. One doc says it’s the cause. The other said it was too small to cause the problem. Been in a walking boot off and on for 3 months. Not better! No talk of an mri. Thinking this is next step.
Thank you for telling us the "difference." Mine is definitely insertional tendonitis.
You're welcome!
How are You feeling after a year?
I'm good, thanks for asking. Hope you are well too.@@wojtekwozniczka492
I had Haglunds resection and achilles repair. No to little pain, but I cannot get that "tight" feeling to go away. When sitting, I cannot put my knee over my foot. Any suggestions would be greatly appreciated. Thank you for your videos.
The best way to get rid of tightness is usually through doing exercises (active movements through range and strength training is usually better than stretches alone)
If you wanted help figuring this out and getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
Hello again! I definitely have this ailment as well as what appears to be a prominent Haglund’s deformity (only on this foot). My ped dr added heel inserts in October and recommended physical therapy, but do you think the deformity will preclude any healing? I’ve now had this pain since a sudden twinge I got playing tennis last May (stopping suddenly). Limping for 9 months! My dr says I’m a good candidate for surgery where the tendon is split like curtains and the deformity is ground away. What would you suggest? Thank you!
You can heal despite the deformity - I've made a video explaining it: ruclips.net/video/Q5ay6kc2x2g/видео.html
@Treat My Achilles how to avoid achilles shortening and be less elastic once using Higher drop and not streching. I tried to use shoes with higher heel but achilles hot stiff and my range is shorter and shorter. I think I has issue in insert area, Should I do streches even it's not recomended?
If your Achilles is hot and stiff it means that there is something that is very flared up and if it is your insertional area, it may be the bursa because it sounds like something that is inflamed. Stretching tissue that is hot and stiff will only make it hurt more later. It is really best that you get it diagnosed properly and then get the right advice for what is going on. The stiffness will go if you can calm the tissue down.
I have been dealing with pain in the area you described for over 2 years now. I play soccer competitively and haven’t been able to plant my left foot (injured achilles) with the normal force when going to pass or shoot since. Beyond the inserts and reducing the calf raises (which I’ve been doing religiously without seeing much progress) what would you recommend doing? I would ideally like to continue to play through it but understand that rest is probably needed
Hi Jake, the only way to really give you a useful answer is to do an assessment of your situation and to establish your Achilles's current strength and sensitivity to loading activities - because this will determine what we suggest you should do. What I can say is that if you've been doing heel raises on a regular basis without seeing improvement, then it is likely that the number, reps, sets, load and method you're using needs to be adjusted as it is clearly not producing any useful results. With regards to playing - it may be that you need to avoid it until you've restored your strength. If you wanted an assessment and rehab advice, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/ My colleague Kevin is most experienced in helping soccer players and he'll be best suited to help you with this - you can read more about him here: www.treatmyachilles.com/kevin-finn
@@TreatMyAchilles Can you describe or give pointers to how to establish your Achilles's current strength and sensitivity to loading activities?
Hi! I happen to have had this pain for some weeks when walking and it seems that simply by forncing my foot arch to lift a bit, I don't have pain at all. It seems that I have flat feet, should I get an arch support or smth?
It maybe worth testing, but we can't really advise on that without assessing you.
My doctor recommends me to try hyaluronic acid injunction on my insertions Achilles’ tendon. Do you recommend this and any side effect on that?
Did you mean "injection"?
How did it go for you??
I have had tingling around the edge of my heels. The podiatrist said it is due to the tight soft tissues and recommended Graston Technique. PT said i may have insertional achilis tendonitis. Long story short, i am still suffering from it. Appreciate it if you can share your thoughts.
Tingling is often a sign that a nerve is irritated. Depending on which area of your heel you're feeling it, it can either be coming from your back (L4 or L5 nerve roots) or it can be one of the local nerves (e.g. posterior tibial nerve and its branches or sural nerve etc.). So this may be something to check.
This is what I have. How to fix? Acupuncture?
I had acupuncture on my Achilles years ago, no effect. But I was sceptical of the treatment before it started.
There is no scientific evidence that acupuncture works as a treatment. Possible placebo effect with regards to pain reduction.
I think i have insercional tendinitis on left heel but also feels very sore on the midportion. Fisio told me yesterday, ususally is on milportion but sometimes the injury gets up (inflamatory process) and can also get on other tendons high up on calf and knee. Its true? And what exercises to do in this case? In my right foot its almost midportion and high up when the tendon gets together on the calf muscles...
Your physio should have given you exercises yesterday because we can't really know what is right for you without assessing you. But usually you choose the exercises according to what is best tolerated and what area is most sensitive. So if you do have insertional as well I would likely start doing it to floor level only. You can find more advice on exercises here: ruclips.net/video/Dp8gzq9zoy4/видео.html
Interesting advice. I just had an a doctor recommend stretching constantly with an insertional issue. So you're saying no stretching?
No stretching - rather use heel inserts and gentle movements avoiding the stretch position. You can find advice about heel inserts here: ruclips.net/video/crzrN0KseWg/видео.html
Hi, I was wondering if I already have custom insoles made for plantar fasciitis, but they drop down a little at the heel part and slightly put my foot into a dorsiflexion (because it's like a cup to hold my heel in and it's softer than the rest of the insole), should I get new insoles made? Is it possible to get a 2 in 1 that tackles plantar fasciitis and also achilles tendonitis?
You likely just need a piece glued onto the bottom of the heel of your current insoles to lift them a bit. But also just try wearing shoes with heels first with your current insoles and see if that helps.
Thank you for this video. If I’ve been doing 20kg weighted standing heel raises with straight and bent knee for 2 months without pain, when should I start considering doing off a step?
I don’t want to too soon and restart the healing process. Is it better to continue adding weight rather than move to over a step for now?
I think you are safe to move to a step but I usually suggest the following to my patients:
1. When you first move to the step, reduce the weight e.g. use 15kg so it is easier on the tendon. See how it copes with it and then increase again slowly.
2. Only do the straight leg ones over the step - the bent knee ones already stretches the tendon and you don't really benefit from doing them over a step.
Thank you. I’ve just started doing them off a step and reduced the weight to 15kg. So far it’s generally fine but I do get some mild discomfort, kind-of like a hot sensation at the insertion, for let’s say half a day following the heel raises over a step. Is this a normal response where I can likely continue slowly with this next phase?
Im going through this now tried everything, 2 physios a chiropractor and even tried acupuncture 3 sessions, absolute agony and no improvement, Iv been doing tip toe raises for 3 days and seeing some improvement but still a way to go, really missing playing fottball.
Best of luck!
R u Ok now??? Or still suffering
@@Priyan0000 Still not sorted, Iv had shockwave therapy which helped but not there yet, rest does nothing to help you have to exercise your way through it, good luck.
I have insertional tendin rupture from Moto accedent and i had surgery of 5 weeks with a cast as doctors said in the aurgery they used Screw supporter that had attached on the insertional tendon and and heel bone , so i am a remote area no physiotherapist, some one could support the next protocol and the physiotherapy needs , i am so appreciated if would help that matters????
This is something our team can help you with via video call as long as your doctor has said it is OK to start rehab and you provide us with the reports from your surgery etc. You can find more information about the video consultations and how to book it on our website: www.treatmyachilles.com/
Hello , how do I know if I have a bursitis or an insertional achilles tendinopathy? Is there an easy way to figure out at home? Thank you!
Not really - if it is very puffy and swollen it is usually safe to say there is bursitis as well but it can be present without too much swelling. Only scan can truly differentiate. But to be honest - as long as you adjust your rehab and walking and shoes to all be done with minimal pain, both conditions will calm down.
Is it the same treatment If you have pain inside of the healbone where the achilles attaches?
This is what I have. The pain is ONLY on the back of my feel right behind a tiny bone spur where the Achilles attaches. Ortho doc said it’s intentional Achilles tendinitis.
@@DeadGame0234
Did you mean "insertional"?
hi just wondering if I am feeling achilles tendonitis right now or just an ankle pain/sprain at the top of my heal, I felt this after my first cycling experience yesterday because of wrong pedaling position and this is the first time I've felt like this plss help!!
Hi Roel, I can't really tell without assessing you. If it only happened recently then allow it a week or 2 to calm down - it may just be sensitive due to the new action rather than being a proper tendinopathy. If it continues to give trouble, you're welcome to consult one of us via video call: www.treatmyachilles.com/
I have had this for almost 3 years... It started when I got new vibram fivefingers, that were extremely tight at the back of ankle. And did some hill training with them. I though that those fivefingers would loosen - nope. At that point I had done barefoot/minimalist running for 8 years, so it was not the problem of zero drop shoes, just that one lousy pair of shoes.
I have been running with this injury all this time, when pain gets bad, I take a day off and the next day heels usually feel ok. But it really restricts my running, I cannot do daily more than something like 10-15 km slow running, longer distances and higher speeds makes heels really painful.
I feel bit reluctant to using shoes with heel raise, though..
Hi… i’ve had this for 7 years and i don’t know what to do i’ve done the shock wave therapy and even plasma therapy still it didn’t work but i haven’t really followed through with a 6 week programme of heel raises and all that
37 year old male and I have been suffering with what I believe is insertional achilles tendonitis for 1 year. Nothing seems to be working and 2 MRI’s have shown no issue. I also have low dorsiflexion in the same foot. Shall I avoid improving dorsiflexing from the floor (e.g. squat positions) as I’m wondering if this could have something to do with my issue? Really struggling to walk longer then 5 minutes and would welcome any advise please.
Yes, if you're actively trying to improve dorsiflexion stop that for 2 weeks and see what happens - also in that time wear shoes with a heel on it to take all strain off that area. If you see improvement (it won't be full fix yet) then it means you're on the correct track and I would continue avoiding that position for a few more weeks. But also need to add in some strength work (avoiding the stretch position).
If you wanted more specific rehab advice and help with getting back to your normal activities, this is something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
i just recently started feeling this. it's a slight ache. sucks that i may have to stop playing football (soccer) for a few weeks 🙃
I found that sitting at in my office with feet flat on the floor would cause the area to get very inflamed, best to elevate the foot or place it out in front instead of directly below. 6-7 hrs a day in this position was a big no no until I realized what was happening.
Thanks for sharing! We have video specifically about sitting and Achilles injuries scheduled for release on April 2, so look out for that, if you're interested.
That would explain why I can no longer wear flip-flops but I'm ok with heels. I'm also on in trainers... would being a front sleeper aggravate it? I feel it is over stretched down but I really struggle with any dorsifexion. I have to go down stairs sideways... embarrassing at 47 ...
When you sleep on your front it likely just gets stiff in that pointed position = then feels super uncomfortable to walk first thing am. Things that can help you get going is actually just moving your foot gently 20 times (not stretching but moving to point of restriction to improve circulation) before you get up and also instead of walking barefoot in house just slip some shoes on with slight heel on them for going down stairs.
I have this problem and it started 1 year ago. I tryed stretching but it was not helping. Now I use high heels and I don't fell pain, but whenever I walk with flat shoes it hurts again. I am starting to feel the only option is surgery...
R u ok now ???
Or still suffering🥺🥺
Without surgery or with surgery????
If compression makes it worse, how come mine is always so sore in the morning after sleeping? My foots natural position while I sleep is pointed down. Should I get one of those socks that keeps the foot semi flexed upwards while I sleep? I also have mild plantar fascia on the same foot and me arches burn lol. My right foot is just a hurting unit where my left has like no issues. I'm 30 and I'm not even that active to where running has caused this since I don't run.
Because your muscles contract so much. If you have this, after you get the inflammation down brute you get out of bed you have to do exercises and get the blood flowing and then don't walk around barefoot but get oofos
Hi, the pain that flares up for me is occurring at the insertion point, and I've been dealing with it for a couple of months and have finished 4 Shockwave sessions over 5 weeks. It has improved but it still does come back. How do you suggest to proceed? Some days are pain free other days i am limping around
What is Shockwave?
@@kedabro1957 it's a machine that sends a fast wave of energy into the muscle.(RUclips has great videos of the machine being used)
@@user-eb5zu9fv4gR u ok now
Or still suffering????
Hi. Strange... From what i see in the video i have chronic insertional achilles pain but was given eccentric exercise for bending the calves by your physio team member
My name is neeteej beekawoo and i did my 1st online diagnosis yesterday
is there any limit in calf stretches for insertional tendonitis? like calf board is okay to use?
Calf stretches usually make insertional Achilles tendonitis worse - we don't prescribe them to your patients. They can be introduced once you are fully recovered but then it is best to do them gently and not for long holds.
In my case, i dont have insertional and also not non insertional, but somewhere betwen. Whay do you recomend?
Hi there,
We cannot provide individual treatment advice without doing an in-depth assessment of your injury and your personal circumstances, as the advice might not be appropriate for you. You're welcome to book a video consultation with one of our physios if you would like an assessment and a personalised treatment plan: www.treatmyachilles.com/
Hi, I have had insertional tendonitis of the Achilles tendon for several months. I just started physiotherapy exercises. I wanted to know if swimming is an allowed activity and that it does not make the situation worse in any way. Thanks
Hi there,
We have a video about that: ruclips.net/video/avm15HNAU4A/видео.html
Hope it helps!
@@TreatMyAchilles Thank you! And the abdomnal crucnh exercise like this can be done without problems? ruclips.net/video/UG29K9woDus/видео.html
does the insertional achilles cause also lots of inflammation at the achilles mid portion? or its two different injuries because I think I have both
You can have both but sometimes it just refers the pain to that area. Make sure you rule out other causes for the pain e.g. gout, inflammatory arthritis, if you have any family history of this
Would a posterior heel spur in this region be treated the same way? Do spurs in the insertional Achilles area usually require surgery?
I'm actually busy researching this exact question at the moment for another video. What we see in practice is that cases where a person has a spur can often take a bit longer to recover and be more sensitive and easy to flare up. The research seems to agree with this and it does seem that you can recover without surgery but that it depends on the size of the spur as well.
@@TreatMyAchilles Thank you. Not sure what size my spur is. Will see a doctor next week.
What kind of stretches are also the best for it?
Stretches are contra-indicated and usually makes it worse. You want to be doing strength training. What strength training you do, will depend on your specific case and how sensitive your tendon is. A good place to start is usually heel raises down in shoes from floor level but they should then be progressed as your tendon heals.
This is also something that our team of physios can help you with via video call. You can read more about how the online consultations work here: www.treatmyachilles.com/
i recently got diagnosed with insertional achilles tendonitis and got offered a cortisone injection on my heel , the pain subsided for about a month but the pain came back worse. i have been wearing heel lifts and been doing pyhsiotherapy for about 3 months now and it just doesnt seem to be getting better. ive also seen a podiatrist and he just said to change shoes and showed me the same heel lifts.
what do you reckon i should do next thank you.
Hi Henry, it's difficult to advise without assessing you because I don't know what your life is like, what activities you do or what you mean by physiotherapy. If it means that a physio has been doing hands-on treatments e.g. massage, ultrasound etc. then you're likely wasting your time as those things doesn't work for this condition. It needs strength training at the right level but something else that may be useful is shockwave. It doesn't work for everyone but it can be effective to reduce the pain in insertional Achilles tendinopathy. However, you still need to strengthen the tendon even if you do decide to have shockwave.
@@TreatMyAchilles thank you i do alot of running and sports in my daily life , i have stopped it completely now and wanting it to heal first until i return to any running. thank you giving me this advice it has really made it clearer. you mentioned strengthening the tendon will that take away the pain eventually or will that help the pain and if so what are some excercises i can do. thank you!
@@henrylee5083R u Completely Ok now
Or still suffering🥺🥺?????
what exercises should i be doing ? 3x15 single leg raises are making me worse every day - should i just do isometrics ?
thanks
There's not simple answer to that one - I explain how we decide this for our patients in this video: ruclips.net/video/bL6KiOsqh94/видео.html
does anyone else have both insertional and mid portion tendinopathy. I'm tender in both the tendon as well as the heels. On both legs. God help me!
i love your accent!
While I was recovering from a calf strain in both legs, I think I developed insertional Achilles tendinitis in both heels. While I was using heel lifts for calf strain, I took off the heels after 2 weeks and within a few days, I started having pain in my heels where the Achilles join. I think this is because my calves remain very tight due to the scar tissue that forms while healing. I am currently using even higher heel cups due to heel pain. It feels more comfortable and started to feel better. However, when I used it for 2 weeks and tried to reduce the height of the heel, my heels flared up because my calves were still very tight. I raised the heels back up again. The flare up seems to have subsided now. I started massaging my calves with a massage gun to relieve tension. What would you recommend in this situation?
Start strength training with heel raises still in shoes and then gradually reduce the height as you gain strength.
Is recovery time for this the same as if its up higher?
It might take longer, because insertional Achilles tendinopathy is more prone to flare-ups, so it might take longer to settle down.
@Treat My Achilles Is it normal for the whole surrounding area of bone to also be super tender to touch. Insertional achilles is the worst type of tendonopathy I have ever had, it just never goes away. I use anti inflams, ice, heel lifts, soft heeled shoes, isometrics etc etc and it never goes anywhere. I have to hobble in excrutiating pain for the first 3km of any run.
I experience exactly the same problem. More pain on the medial aspect of the heel bone than the posterior. Pain aggravates once i start walking after a certain period of rest.
@@preetleo09 Its horrific. Im about to give up/back off my running a lot. The way its affecting my day to day life is now really bad, cant even walk around the house properly.
@@DMGC529 I just got this for the first time. I ran 5k every day for 10 days, and now i can barely enjoy moving at all. I hope this isnt the end for me! I am very scared.
Do you also wake up with it very sore and limp around for the first 10 minutes?
@@NooDLES411911 yes but that happens wth most achilles tendinopathies.
What is the injury that swells up on either side of an insertional Achilles injury?
You may have a bursitis - that can cause quite a lot of swelling at the heel: ruclips.net/video/B1LMKwEZ5mo/видео.html
What if you have both insertional and mid?
Then you treat it as insertional because that treatment will work for both and you can then just adjust your final stages of rehab to also make sure the midportion is fully rehabbed.
I did it for the first time but I felt pain under the toes of my foot. I dont want to get metatarsialgia. Any advice?
What did you do for the first time?
@@kedabro1957 heel raises
I suffer with pain at the back of both heels. It started at the start of 2020 when I was running 50 miles per week. I’m now running 30 miles a week at a very low intensity. The first 10 mins of running are a little uncomfortable, but after that I can run pain free. After the run, my feet are very stiff and I limp around a bit. The backs of my heels are painful to touch. Can you recommend any exercises I should be doing to help recovery. Thanks.
Hi Neil, it's not actually as simple as just doing some exercises. You need to look at all the activities that load your Achilles and reduce them to a level that does not cause you to limp afterwards - otherwise it won't recover. The exercises also has to be pitched at the right level for you - it would really be best to consult someone who can assess you by making you do some test movements and properly listen to how your symptoms act according to different times of day and activities and then design a programme. That programme also needs to be progressed as you grow stronger otherwise your recovery will stagnate. Hope this makes sense.
@@TreatMyAchilles Thanks for the reply and yes that makes sense. Guess I was hoping for a quick fix ☹️
😔🍀good luck with your recovery
Also a runner. Same kind of symptoms you described. In the end, the only thing that worked for me was stopping running for 6 weeks. I was able to bike and inline skate during the 6 weeks.
@@neilporter6908R u ok now???
Or still suffering🥺
I am a bit confused. you dont recommend any exerciese for insertional achilies tendenitis?
We do - you must just adapt them so you don't irritate the tendon - we discuss exercises and how to adapt them for insertional tendonitis here ruclips.net/video/Dp8gzq9zoy4/видео.html
I’ll rest it for a month and play soccer again. It’s been almost 2 years like this. I really need to rest. I can jog but I can’t sprint. It will get sore and I’ll start walking with a limp for a week. I just need to rest, period. How long should I rest for and avoid sporting activities? Weeks, months?
Jose, you need to be strengthening it back up to be able to handle the loads from running and soccer. Rest just makes the pain settle down but it doesn't actually strengthen the tendon. This video may also be useful ruclips.net/video/XMvcJIrqYhY/видео.html
@@TreatMyAchilles thank you so much! You’re right, no wonder I think I’m fine and when I start playing I have to start over to recover. Rest and strengthening is Key. Thanks again!
What exercises would you recommend for this issue?
It depends on your specific case but usually heel raises only to floor level (not over side of step) - I discuss exercises in detail here: ruclips.net/video/Dp8gzq9zoy4/видео.html
@@TreatMyAchilles thank you