achilles tendonitis – Anderson Podiatry Center

Achilles Tendon Heel Pain: How to Avoid it and What are Your Best Treatment Options.

Posted on June 23, 2021June 30, 2025 by admin

Treating the root of the problem for an achilles tendon injury

The Achilles tendon originates from the large calf muscles in the back of the lower leg and attaches to the back of the heel bone. Its function is to push your heel up off the ground and to propel you forward. Pain can occur along the tendon, that band of tissue just below the calf muscle, or where the tendon attaches to the heel bone. The pain can be very disabling, not allowing you to walk or run anymore and or do other activities. It may limit the range of motion in your ankle because of the pain. You may also notice swelling of the tendon associated with your pain. If the back of the heel bone appears enlarged, it may be from the Achilles tendon. So even though a heel spur or boney growth on the back of the heel may be noted it is now thought that in many cases the pain is from the tendon. These problems are referred to as a Haglund’s deformity or a retrocalcaneal spur. This goes against much of conventional medicine as our approach but the high success rate of our treatments for an achilles tendon injury that are directed at treating the tendon and not the bone prove otherwise.

Diagnosis

The diagnosis of achilles tendon injury and heel pain is usually made by the doctor’s clinical exam. However, diagnostic ultrasound or MRI may also be used for a more accurate evaluation.

Causes

Overuse – This is a common cause for injuries sustained to the achilles tendon. If you overdo it without gradually increasing the activity so your body has time to recover this can be a problem.
Types of activities – Some activities may make you more susceptible to achilles injury and heel pain. This would include running up and down hills, or any activity where impact or jumping is involved.
Age – As we get older it is thought that the tendon can become weaker. When this happens the tendon gradually starts breaking down.
Foot type – Improper foot structure and biomechanics may also play a role. An example is a foot that over pronates, flattens, which may cause more pulling on the tendon. A high arch foot may allow the heel bone to rub against the Achilles tendon.
Weight – Excessive weight can put excessive load and stress on the tendon.

Prevention

Shoe gear – Avoid wearing shoes when your active that are broken down. The lack of support may lead to heel pain or Achilles’ tendonitis.
Heel lifts – If your just beginning to experience pain using a heel lift can take some of the stress off the tendon.
Changing activities – Consider backing off activities or changing the activity to one that puts less demand on the tendon.
Stretching – This may also be important both before and especially after activity.
Anti-inflammatories – taking anti-inflammatories short term may also be useful but long-term use should be avoided as they may have a negative effect on your bodies natural healing processes.

Treatments

Treatments that your doctor may recommend can include resting the area and sometimes immobilizing the area in a walking boot. Physical therapy along with heel pain stretches may also be considered. Also, anti-inflammatories may also be suggested. These treatments can work in the early stages but if the problem is more severe or chronic maybe band aid approaches.

The top four treatments we offer that get at the root cause of the problem. It may not be tendonitis!

Regenerative medicine – new terminology Achilles TENDONOSIS
The use of stem cell treatments for over the past decade have proven to be phenomenally successful. The new way of thinking about the Achilles tendon and heel pain is that the problem has more to do with the tendon breaking down and having small, microscopic tears then being inflamed. This is called tendinosis. That is why the use of regenerative medicine make more sense. It’s used to repair damaged tissue rather than treat inflammation which may not be present.
Orthotics – The myth of the tight Achilles tendon
Orthotics are commonly used and have a high success rate, why? We know that with every step you take your heel bone rolls from side to side. This motion is thought to put more pulling on the tendon along its length and where it attaches to the heel bone. A custom made orthotic greatly reduces this motion and often eliminates the problem. This goes against the conventional thought. Yes, the pain can be from a tight Achilles but from our experience its less likely than previously thought.
Shockwave – Shockwave is also a treatment that has been successful. Shockwave is similar lithotripsy where sound waves are used to break up kidney stones. This type of treatment sends powerful sound waves in the Achilles tendon area and traumatizes the tendon, but this stimulates your body to send more cellular components to the area that help repair the tendon. This has also shown quite significant relief for patients with this issue.
Accelerated Laser Pain Therapy – Laser works on a cellular level helping the mitochondria of the tendon tissue repair the tendon. The mitochondria is the area of each cell that creates energy and is responsible for cellular repair.

If the above options fail, surgery may be considered to treat the injury.

Surgery can also be effective but is exceedingly rare as the approach we with orthotics, regenerative medicine, shockwave and laser as options is highly successful at getting you back to full activity.

So if you find yourself dealing with this, understand that you can start out by treating on your own by the suggestions offered in this blog. But the longer this goes on, it’s more important to seek professional attention to ensure that you’re having this treated aggressively. There is a solution for your Achilles tendon heel pain. It’s important that you have consultation with somebody that is proficient providing the treatments we’ve recommended for injuries of this type. If your getting nowhere and feeling frustrated with your present situation please feel free to contact and we’ll help you to evaluate if our approach is appropriate for you.

What Are the Benefits of Wearing Orthotics?

Posted on December 23, 2020July 1, 2025 by admin

As a podiatrist, we often recommend orthotic devices as they can be of great benefit for the wearer. Before we dive into the benefits of wearing orthotics, let’s answer the question of what an orthotic is, from a podiatrist point of view.

In today’s world, it seems like everyone is marketing their orthotics. You see them in retail stores, shoe stores, ski shops, and even Facebook ads. As a podiatrist, the whole concept of what an orthotic is has been muddied. My opinion is shared by my colleagues- podiatrists believe there is a non-weight-bearing, neutral-point position of the foot. And so, whatever technique is utilized to fabricate an orthotic, an impression of the foot should be taken in this position.

The foot is positioned at its optimal functional position. Any kind of orthotic that is made from a technique that involves any partial or full weight-bearing, we feel is not done accurately. There are small, torsional abnormalities, sometimes between the front half and rear foot, that are not taken into account when the foot is bearing weight. A podiatrist’s orthotic is much more precise and is able to support and control excessive motion in the foot more accurately. That is not to say that an orthotic made from a weight bearing technique won’t work, but the chances are greatly reduced. It is a common story of patients we treat.

Benefits of Orthotics

I am writing this blog at a time where some advocate barefoot running, or running in minimalist shoes. So hear me out from a foot specialist’s point of view. Outside the office, when someone finds out I’m a podiatrist, I’m often asked what types of shoes are best. Using tact, I’ll make the point that it’s like asking an optometrist what lens prescription they should have. We expect that kind of precision for our eyes, but medicine seems to not think the same rules apply to the feet.

If one has excellent foot structure, I’m not opposed to the idea of barefoot running. My point is that it all starts with what foot type you’ve inherited. It has been observed that 70% of people may have feet that overpronate. Pronation is simply the motion that involves the flattening of your feet. The foot will flatten the arch and abduct, or move away from the other foot. A more ideal foot type does not overpronate, and the actual bony structure helps stabilize and support the foot. There is a locking mechanism that takes place in the bones in the midfoot area. Those that have feet that are much more flexible, or pronates more easily, are thought to have a foot where the bones do not lock and support the foot. Therefore, soft tissue needs to. This can cause excessive stress on structures such as tendons, joints, nerves and other soft tissue structures such as fascia. So, how do you know if custom orthotics might be useful? The following are some tips and specific conditions you should know about.

If you keep getting the same type of injury or foot pain over and over, or if you’ve had that injury for an extended period of time, it may be time to look into orthotics. Especially if you’ve already tried resting, anti-inflammatories, and icing the area. This could also be an indication that your foot type lends itself towards having specific issues.

Soft tissue problems

Plantar fasciitis and Achilles tendinitis
- One of the more common problems is plantar fasciitis commonly referred to as heel pain. Orthotics will reduce the stress of the plantar fascia pulling on the bottom of the heel. For Achilles tendonitis the stress on the Achilles will be reduced.
Foot deformities
- Bunions may also be helped with orthotics. If you have an enlargement on the inside of your big toe you may benefit especially in the early stages of the deformity.

Nerve problems

Neuromas and tarsal tunnel syndrome
- Neuromas are a nerve enlargement that can occur in the ball of the foot. If you’re experiencing burning, tingling and numbness on the bottom of your foot, you may have tarsal tunnel syndrome.
Joint pain
- Arthritis in the foot can also be treated with orthotics and it’s a safer, drug free approach. This may include big toe joint pain commonly referred to as Hallux limitus. Also, ankle pain and pain in the small joints in your arch.

Final Thoughts

You may save money as you’ll quit shopping for shoes to solve your foot problems. The orthotic can be taken from shoe to shoe and will neutralize the less optimal shoe as it’s designed precisely for your foot.
You’ll avoid injuries as certain foot structures lend themselves to certain injuries
You could lose weight and sleep better as you become more active.

If you yourself frustrated with your inability to stay active, please consider a consultation with us to truly understand more about the foot structure you have and how it may be the issue that no one has explained to you. There are many benefits of wearing orthotics, so it’s time you discover for yourself!

Are Custom Orthotics For Foot Problems Right For You?

Posted on December 8, 2020 by admin

There are two basic principles to consider when dealing with your feet and your lower extremity pains that you may have. First, do you think you have a foot that over flattens, otherwise called pronation? As foot specialists, we have been trained in biomechanics and believe that most patients are born with different foot types. If you tend to overpronate the bony structure of your foot, you cannot adequately support the foot. This results in soft tissue structures being stressed more. Orthotics simply position the foot so that the joints can support the foot and demand less of other structures.

Secondly, do you have a condition that continues to plague you in spite of attempts with anti-inflammatories, icing, resting or maybe even physical therapy? Do you find that if you lay off from running or walking and return to it, the same problem occurs? If this is you, then this blog is right for you! Let’s find out if custom orthotics for foot problems are right for you.

Over-pronation

Let’s address your first concern. Over pronating is a very simple concept to understand. People tend to flatten their arch or roll their foot inward too much and too often. The old adage is, if you walk in the sand and you can’t see much of an arch, this could be an indication of pronation. This is somewhat true in most cases, but it may be more complex than that. Some people have an arch that doesn’t over flatten; but if you look at their heel from behind, their heel tends to roll in quite a bit. It does not stay perpendicular to the ground.

Different kinds of feet present different kinds of pronation. Sometimes, a professional is the best to tell you if you are an overpronator. If you have tried various treatments and you have had a problem that’s been persisting; for over one, three, six or twelve months – it is an indication that your foot structure needs additional support. The following are some conditions that are oftentimes bettered or totally eliminated with the use of orthotic devices.

Achilles Tendonitis and Plantar Fasciitis

Pain on the bottom of the heel is referred to as plantar fasciitis. It’s one of the most common problems to be treatable. Tendon on the backside of your heel or running up the Achilles tendon, is, oftentimes, Achilles tendonitis. Orthotics can treat this a great deal. In many cases, treatment options such as anti-inflammatory stretching and physical therapy just don’t knock it away.

Bunions and Foot Deformities That Are Treated With Custom Orthotics

Bunions are a prime example of this, especially if it’s in early stages and not painful yet. There is a chance of a foot deformity where you can feel growth on the back of your heel; also called the Haglund’s deformity or pump bump. Patients can benefit from orthotics in this situation. In both cases, the biomechanics of your foot might allow you to have a progression of a bunion or progression of the bump on the back of heel.

Stiff Toe Joint

Also referred to as hallux limitus or hallux rigidus, this is an arthritic condition in its early stages and can be healed with orthotic devices.

Painful Ankle

The ankle in itself can have arthritis and orthotics may benefit that. There are stabilizers or stirrup tendons that help stabilize the outer side and the inner side of the ankle. If you have overpronation, these tendons tend to have to be overused because they’re trying to stabilize the foot that is unstable.

Knee Pain

Orthotics have a proven track record of helping what is called chondromalacia patella, which occurs when the kneecap is not centered over the knee joint, thereby causing arthritis between the knee joint and the femur bone. There are instances when people have a higher Q-angle and their knee angulates inward so the thigh and lower leg are not in a straight line. By supporting the foot more this can lessen the angulation at the knee with every step that is taken. The patella can then stay in better alignment and may be less likely to wear down the cartilage. If you have any of the above conditions or just simply have a problem that persists for a long time, orthotics may be just the way to go for you.

Finally if you find yourself in pain in the ball of your foot maybe you’re feeling like your sock is wrinkled but it isn’t. You may be suffering from a nerve enlargement called a neuroma (mortens neuroma) . Orthotics can help as they support the area to lessen the rubbing of a ligament against the nerve.

This blog will serve as a guideline for your consideration of custom orthotics for foot problems and what they are useful for. Depending on your condition, orthotics may be a part of the solution or the only treatment that is needed. So remember to consider if you think you’re an overpronator and are having difficulty getting rid of a chronic problem in the foot or ankle.

Which Running Shoe is Right for You?

Posted on July 19, 2017July 1, 2025 by admin

Whether you are new to the running game, or starting a new kind of activity like hiking or cross training, picking out the right kind of shoe can be a stressful task. As a podiatrist and an athlete, I will tell you that it is very important to find a athletic shoe that fits your specific needs. So here’s a few tips to help simplify the process. Happy shopping.

1. The shoe should fit the activity

The first step is to decide which activity you want the shoes for. Do you like to run on the road or on trails? Do you spend most of the time cross training in the gym doing classes like Zumba or Body Pump? Road running shoes are designed to be light and flexible with cushion and not a lot a tread. Trail running shoes add aggressive tread to provide protection while on rocks and uneven ground. Cross training shoes are designed to provide more contact with the ground while still giving you support and comfort. So make sure you think about what activities you will primarily be wearing these shoes for.

2. Find out your foot type

Now that you have a primary activity in mind, we can we start to look at your foot type. Typically, shoes are made for 3 different foot types.

The most common are neutral pronation shoes. This is for people whose arch is maintained during the gait cycle. When you strike the ground, initially your heel will slightly pronate or turn outward to allow for shock absorption. You may notice slight wear on the inside portion of your shoes at the heel.

The next is overpronatation. This is for people who are generally more flat footed and their arch is not maintained during the gait cycle. In this foot type you will notice excessive wear on the inside of the heel of your shoes and wear along the inside at the ball of your foot. For this foot type, added stability is placed into the shoe along the arch to help prevent your arch from collapsing. Often you will notice a different color of material along the midsole of the shoe, which is generally stiffer then the remaining portion of the sole.

The last type of shoe is for people who have high arches, or who supinate (also called underpronation). In this foot type you will notice excessive wear on the outside of the heel and along the outside of the ball of the foot. This is the least common in runners, but with this foot type, added cushioning and flexibility is necessary.

3. Now it’s time to try them on

The most important thing is comfort. Try to shop for shoes later in the day when your feet are generally a little more swollen. You will want about a thumbnail width in added length at the end of the shoes, but the width should be snug. You do not want to feel like you are sliding around in the shoe. Consider having your feet measured to ensure a proper fit. Also, if you wear orthotics, bring them with you to make sure they will fit appropriately.

When it comes to brands of shoes, I have tried multiple over the years. Generally, most are made similarly with the different characteristics I have mentioned above. I typically will defer to comfort over a certain brand and recommend you try various brands to see which one you find the most comfortable. Most runners I talk to have found one they love, and will keep going back to that brand and model of shoe.

Here’s one more important piece of advice for all you dedicated athletes out there: if you find yourself facing a training-related injury, such as plantar fasciitis, tendonitis, or a stress fracture, it’s crucial not to push through the pain. Continuing to train on an injured foot can exacerbate the issue and prolong your recovery time. Instead, be proactive and take a well-deserved break from your training routine.

At Anderson Podiatry Center, we specialize in treating sports-related foot and ankle injuries, and we’re here to help you get back on track as quickly as possible. Our experienced team will provide you with expert care and a personalized treatment plan to support your healing journey. To make an appointment, click here.

Additionally, if you’re in need of the perfect athletic shoe to aid your recovery and prevent future injuries, we recommend visiting our friends at Runners Roost. When you drop by their store, be sure to mention that we sent you their way. They have the expertise to help you find the ideal shoe that suits your specific needs and enhances your athletic performance. Your health and well-being are our top priorities, and we’re dedicated to ensuring you receive the best care and guidance on your fitness journey.

5 Steps to Race Training (Part 1)

Posted on June 9, 2017July 1, 2025 by admin

As a podiatrist and a runner/triathlete, I know personally and professionally how important it is to take the proper steps to train for a race. Perhaps you have never run a race before and are training for your first 5k. Or, maybe you are more advanced and are ready to take on your first marathon. Either way, these five steps will help your body adjust properly and avoid injury so you can cross the finish line in victory.

1. Start early

If this is your first event of the season, you need start training at least 3-4 months in advance. Keep in mind that the longer the event, the sooner you should start your training. Also, if you have no base to start from, you may want to increase the time you take to prepare. For example, most half marathon programs are 10-16 weeks long, but assume that you have a running base to begin with.

If the plan has you running long runs early that are twice as long as your current long distance runs, you may want to pick another plan. Most plans are labeled beginner, intermediate, and advanced, so make sure you pick one that is appropriate for you. I also recommend a longer plan to give yourself more time and wiggle room in case you have a sick week or two.

2. Never skip the warm up

As a beginner or novice runner, the warm up is not as essential, but as you start training for longer distances and larger events, the warm up becomes critical. As you are training harder and faster, your body has the tendency to tighten up. I experienced this myself this year as I began my training.

You will need to spend more time stretching and warming up as you progress in your training. Stretching when you are finished is also essential. Your muscles are still warm, so stretching at this time provides a huge benefit.

3. Cross train

I am a triathloner for this very reason. I believe doing one repetitive motion will over-develop certain muscle groups and wear out joints sooner. At the same time, as a triathloner, you can still have the same issues. I believe in plans that have built in rest days and or range of motion days. My body is more stiff in general and so I need to spend extra focus on stretching. Spending some time on strength training as well can be very beneficial.

This can be as easy as adding push-up and pull-ups with some core exercises or light weights with high number of repetitions. Runners will typically benefit from lighter weight with higher repetitions rather than a body building style with heavy weights and fewer reps.

Stay tuned for steps 4 and 5, coming soon!

If you are having pain anywhere below the knee, come see us. We can help get you back on track as quickly as possible.

To make an appointment, click here.

3 Common Injuries in Athletes: Part 2

Posted on May 16, 2017July 1, 2025 by admin

In the first blog, we talked about stress fractures being the first of the three most common injuries we typically see in athletes. Today, let’s dive into #2 and #3, and talk about causes, prevention and treatment.

2. Tendonitis

Once again, this injury is from overuse. The most common type of tendonitis we see involving athletes is Achilles tendonitis. The Achilles tendon is the most powerful tendon in the body and provides the propulsion strength needing in walking and running. It can often become very tight and repeated stress can cause micro tears in the tendon, causing pain and inflammation. Building rest days into your training can help prevent this injury. Stretching can also play a big part in prevention and can help if you are starting to develop the early signs of tendonitis. Icing the area for a short period of time can also help to resolve these symptoms.

However, if your symptoms persist, then considering more aggressive treatments can aid in the healing process. We avoid cortisone injections in this area due to the high chance of Achilles tendon rupture. We use laser therapy with the MLS laser to help reduce swelling and inflammation in the early stages of treatment. The laser also helps accelerate tissue repair and cell growth. If this has become a chronic issue, then we look at more regenerative treatment options like platelet-rich plasma therapy (PRP) and AmnioFix. These treatments can often prevent you from needing surgery and can help you resume your normal activity level more quickly.

3. Plantar Fasciitis

This is the most common complaint I see in my office. Heel pain affects many people and can be a common injury in athletes. The plantar fascia is the main ligament that supports the arch. It runs from the heel bone to the ball of the foot. As our foot adapts to terrain, the plantar fascia can become overused and inflamed. It too can develop micro tears that cause pain and inflammation. Left untreated, it can become a chronic condition that causes the tissue to become thick and the plantar fascia loses it’s elasticity.

Symptoms often will be worst with the first step in the morning, or after sitting for long periods. In runners, it will often feel better shortly after you begin exercises, but will start to become painful again after longer distances and become progressively more and more painful. If the Achilles tendon is tight, it places added stress on the arch of the foot and often becomes the main cause of plantar fasciitis. Sometimes, plantar fasciitis can respond to calf stretching, but I would recommend coming in for an evaluation first as sometimes stretching can also make it worse, depending on the stage of the injury.

Plantar fasciitis also responds very well to regenerative injections like PRP and Amniofix. Cortisone injections have been the traditional approach to treating this condition. However, they often mask the symptoms, and when the injection starts to wear off, the pain returns. When using PRP or Amniofix, your immune system is recruited to aid in the healing of the tissue. The tissue is actually healing itself instead of just covering up the symptoms. Arch supports (orthotics) can also help to support the arch and prevent recurrence of pain.

Get Back to What You Love

So here’s the big takeaway. There are a myriad of injuries possible for athletes and triathletes, but these three are common because they are caused by overuse. We often treat all three injuries very similarly because of the response we see. Regenerative injections, orthotics, and MLS laser treatment have shown to get patients back to their activities, quickly. Often times, this happens in a matter of weeks instead of months.

Our goal is to heal the injury quickly, control the biomechanics of the foot to prevent the injury from returning, and get you back to doing the things that you love as quickly as possible.

To make an appointment, click here.