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Achilles Tendinitis (or Achilles Tendonitis)
Achilles tendon injuries are one of the most common overuse
injuries in recreational sports.
A very small percentage of
these injuries are diagnosed and treated by doctors of
chiropractic. What is especially interesting is that a high
percentage of these injuries are caused by a posterior
calcaneus subluxation.
The first step in evaluation of an Achilles tendon injury is
palpation of the injured area.
A ruptured Achilles tendon must
first be ruled out. This is done by performing Thompson's Test,
which calls for squeezing the calf muscle and checking for
the normal plantar flexion of the foot response.
If a complete rupture is present, I would recommend a
consultation with your orthopedic referral doctor. Most
cases of severe rupture will be in the group of males over
the age of 40. The majority of non-ruptured tendon injuries will not require surgery if proper conservative care is provided.
Palpation of the Achilles tendon may reveal a thickening of the entire tendon or isolated "bumps." Point tenderness may extend into the musculoskeletal junction of the soleus and gastrocnemius muscles.
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The muscle bellies of the soleus and gastrocnemius muscles may exhibit hypertonicity and point tenderness.
The origin of the soleus and gastrocnemius muscles should be palpated for tenderness.
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Remember, the Achilles tendon is merely connective tissue between the calf muscles and the point of insertion of the calcaneus.
Many cases of Achilles injuries are caused by a lack of flexibility of the calf muscles. The gastrocnemius muscle is stretched with the knee fully extended and the soleus is only stretched with the knee flexed.
My experience is that most athletes only stretch their calves with their knee fully extended and therefore never fully stretch the soleus muscles.
In all Achilles tendon injuries, I adjust for a posterior calcaneus.
In many cases, this is the cause of the injury.
The adjustment is performed by placing the patient prone, with the knee flexed at 90 degrees.
The patient's heel is placed in the web of the doctor's contact hand and the doctor's other hand is placed on the top of the foot.
Force is applied with both the contact and stabilizing hands causing the foot to be "whipped" quickly. An audible "pop" is frequently heard.
This adjustment can be somewhat painful if the Achilles is inflamed. I inform the patient that it may hurt momentarily.
I always repeat this procedure on the non-injured calcaneus.
The rest of the foot, the knee, and the pelvis are always evaluated for subluxations. It is of prime importance that we treat the entire musculoskeletal system.
Poor foot mechanics are another major cause of Achilles tendinitis. Approximately 60% of the population has some degree of foot overpronation.
This rolling in of the foot may eventually lead to overuse injury of the Achilles tendon.
Evaluation of overpronation is accomplished by having the patient alternately stand on one foot at a time. Watch for a medial rotation of the tibia and a dropping of the arch.
If overpronation is present, a custom orthotic is prescribed.
Other treatment procedures for Achilles tendonitis include myofascial therapy, electrical stimulation, cryotherapy, stretching, and ultrasound.
In conclusion, doctors of chiropractic, when properly trained, are the physicians of choice for Achilles tendinitis.
Keith Jeffers, D.C.
San Diego, California
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Jeffers Chiropractic & Sports Injuries
Chiropractor San Diego
7770 Regents Road, Suite 105
San Diego, CA 92122
(858) 452-7770
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Articles:
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"Foot Orthotics - Use in the Treatment of Overuse
Injuries"
"Chiropractor Care for Lower Leg
Injuries" Running Injuries - Shin Spints or ...
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Facts:
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Achilles Tendinitis, one of the more common and difficult injuries to treat in athletes, tendinitis involves inflammation, degeneration or rupture of the Achilles tendon. The Achilles tendon is located at the back of the heel and inserts into the rear portion of the heel bone. The Achilles tendon is surrounded by a vascular sheath which provides the tendon fibers with its blood supply.
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The Doctor is In:
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Dr. Jeffers
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Professional Qualifications
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UTC Chiropractor Office
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Contact Us
The Running Doctor, a San Diego chiropractor provides sports medicine and chiropractic care for: Sports injuries, auto injuries,
low back pain, neck pain, joint pain, wrist pain, shoulder pain,
hip pain, achilles tendonitis, muscle spasms and more...
Many cases of Achilles injuries and tendinitis stem from calf muscle inflexibility.
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