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Heel pain not just a problem for Greek Demigods!

By Daniel Jordan - LifeForce Physiotherapist

Achilles tendon pain is a common condition, and it affects both active and sedentary people, of varying age groups. There are various causes and contributing factors to Achilles tendon pain, including, but not limited to, muscle imbalance, age, metabolic conditions, weight, inappropriate footwear, increase in training load or change of training type or environment. As feet are rather difficult to rest (walking on your hands can be tricky!), it can take some time for heel pain to settle. There are multiple treatments available for heel pain, including physiotherapy, massage, acupuncture, and more invasive modalities such as cortisone or platelet-rich-plasma injections or even surgery.
 
SO WHAT IS THE BEST METHOD OF TREATMENT?

In most cases, conservative treatment should be tried as a first option before surgery or injections. Physiotherapy is a good place to start, and modalities such as massage or acupuncture are worth trying also. Physiotherapy will likely involve a detailed assessment of the biomechanics of your foot, ankle, knee, hip, pelvis and spine, and will often include treatment of some or all of these areas to help your body heal and function the way it is meant to.

Exercises such as eccentric overload training have been shown to be useful in improving symptoms and function, as has exercise and neuromuscular retraining using whole-body vibration therapy (WBVT). WBVT machines utilise standing on a rapidly oscillating plate to trigger a neuromuscular response from your nerves and muscles, and have been demonstrated to improve muscle strength, flexibility, bone density and reduce cortisol (stress hormone) levels, as well as other things. We have a WBVT machine at LifeForce, and it is available for 10-minute training intervals; enquire by phone or email if you are interested in trying it out.

Other physiotherapy treatment modalities that are known to be effective for Achilles and heel pain are massage, stretching, muscle strengthening, dry needling, and joint mobilisation, among other things.

More invasive treatments such as cortisone injections, plasma-rich plasma injections or surgery can be effective (and sometimes not!), but often don’t address the root of the problem.

In our experience, most Achilles and heel symptoms develop over time, rather than as a result of a single event or incident; as such, these invasive treatments could be seen as more of a bandaid rather than a holistic, lasting solution, which often requires a little more problem solving, planning, and mindful management to achieve. Achilles and heel pain often won’t go away on its own, so it is worthwhile seeing a health professional about any symptoms you may have.

References

Cole, Z., Dennison, E. and Cooper, C. (2008). Osteoporosis epidemiology update. Curr Rheumatol Rep, 10(2), pp.92-96.

Ernst, E (1994). Can exercise prevent postmenopausal osteoporosis?. British Journal of Sports Medicine, 28(1), pp.5-6.

Verschueren, S., Roelants, M., Delecluse, C., Swinnen, S., Vanderschueren, D. and Boonen, S. (2003). Effect of 6-Month Whole Body Vibration Training on Hip Density, Muscle Strength, and Postural Control in Postmenopausal Women: A Randomized Controlled Pilot Study. J Bone Miner Res, 19(3), pp.352-359.