Pain in the back of the lower leg associated with inflammation with or without swelling around the Achilles tendon or bursa, which may be worse on movement. Often caused by repetitive stress, trauma, foot wear or foot positional problems and/or muscle imbalance in the front or back muscles of the lower leg.

Diagnosis

Diagnosis of Achilles Tendonitis/ Bursitis is derived from the patient’s history and physical exam with no indicators of potentially serious pathology.

Chiropractors perform a thorough history of complaint and examination (orthopaedic, neurological and chiropractic testing).

Assessment may also include the use of diagnostic imaging including X-ray and MRI or blood tests.

Back-in-Action Clinic Comment

Chiropractic treatment of Achilles Tendonitis/ Bursitis initially is based on promoting soft tissue healing and relieving pain.

Self help recommendations of using ice or heat is often given in the acute stage and it is recommended to limit aggravating activities. Nutritional approaches can be beneficial to help support soft tissue healing.

Cross friction massage and muscle release techniques may be applied. Areas of severe muscle spasm may also benefit from massage or acupuncture. An emphasis is placed on self help exercise which might include self mobilisation, stretching, strengthening and balance training.

Both pain relief and preventative approaches focus on improving the movement, position and stability of the lower leg and related structures in order to reduce the risk of stress and further tissue damage. Core stability exercise often is useful for improving the position of the low back, pelvis and hip. Functional neurological treatment and exercises are sometimes helpful.

Foot orthotics, heel lifts, sitting advice and other ways to improve postural problems affecting the lower leg may be suggested to help prevent reoccurrence. Education on running style and preparation can be useful.

Chiropractic adjusting techniques (manipulation) and mobilisation may be applied to the foot and ankle and to improve the function of related joints in the lower back and leg.