When you overuse a set of muscles, you’re likely to strain the tendons, which are soft tissue structures that connect muscle to bone. The strain may cause a tendon’s sheath to swell or the fibers to separate and pull apart. At the beginning, pain and swelling may be intermittent and resolve quickly. If the muscle group continues to be stressed without time to recover, damage to the tendons accumulates leading to the development of tendonitis and ultimately tendonosis. Over time, the pain and swelling may limit physical activity. At first you may feel pain only during or after a workout, but eventually, as the damage accumulates, your feet may hurt when just simply walking or standing.
A common area of tendonitis is at the back of the heel, where the Achilles tendon of the calf muscle inserts into the heel. With Achilles tendonitis, pain may occur when your foot hits the ground or when the heel lifts off the ground. With insertional Achilles tendonitis, first steps may elicit an achy pain, pain may be worse when going up an incline and there may be irritation where the back of the heel makes contact with a shoe.
Treating tendonitis begins with controlling the pain and swelling. Ice and rest would be first line treatment as ice prevents swelling and reduces pain and rest allows time for tissues to heal. If left untreated, tendonitis may predispose you to further injury such as a tendon rupture. Your podiatrist may prescribe anti-inflammatory medications, steroids or topical anti-inflammatories. Orthotics or bracing may be recommended to immobilize the area or reduce stress to the area. Your podiatrist may recommend a stretching regimen or physical therapy to help relieve tension on the tendon. If tendonitis symptoms persist, injections may be offered to reduce pain. Surgical treatment is reserved for only chronic cases but may involve debridement of the tendon itself, release of adhesions, or removal of bony spurs. Call your podiatrist today if you have questions or concerns about tendonitis.
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