A 35-year-old man, active and athletic, consults for chronic tendinitis of the Achilles tendon, the pain being present for 3 years.
The patient was training in weightlifting and started running. Listening to the advice of those around him, he opted for minimalist shoes. He developed pain in both Achilles tendons. When the pain started, he stopped weightlifting blaming heavy lifting for his pains, but continued to jog. The pain persisted but did not prevent him from running.
In the two years preceding the first visit, the pain remained stable. It occurs mainly on waking up in the morning. The patient feels pain and stiffness for first steps bu once warmed up, the pain subsides. During his runs, the patient feels pain in the Achilles tendons and calves, especially on the medial side. The pain is worse during sprints, which require a stronger contraction of the calf muscles. This pain is relieved by massage, but it comes back quickly.
The patient trains for a half-marathon and has a race scheduled 3 weeks after the date of the first consultation. He is physically active and is in good general health.
The examination reveals that his feet are slightly flat, the sign of Helbing being positive, and tenderness when pinching the Achilles tendon at its superior third.
Achilles tendinitis refers to Achilles tendon or near-heel pain caused by Achilles tendon inflammation. The Achilles tendon is one of the longest and strongest tendons in the human body and attaches the soleus and gastrocnemius muscles to the calcaneus (heel bone). Tendinitis is often caused by overwork and excessive strain on the tendon. The flat foot or tension in the calf muscles can contribute to the problem. In this case, starting a new sport too intensely and with inappropriate footwear that caused tendinopathy.
Achilles tendonitis is a frequent reason for seeking treatments at our clinic and it is a pathology that is treated very well with acupuncture. In this case, for the treatment, we needled the trigger points and motor points of the gastrocnemius and soleus muscles, and two needles were placed precisely at the points of pain on the Achilles tendons. The needles inserted into the muscles were stimulated at 10 Hz for a few seconds and those of the tendon at 4 Hz for about fifteen minutes. The treatment was completed with a tuina massage on the calves to release tensions in the calves and we applied a liniment (Zhenggushui) on the tendon. Some simple stretches and exercises were recommended to the patient to help him relax the calf muscles.
From the first treatment, the pain was greatly relieved and the patient had no pain after getting up in the morning for the following 6 days. The pain started again the day before the second treatment, this time a little more lateral than it was when we first met. The treatment was slightly modified, adding 2 acupuncture points on the medial side of the calf.
At the third treatment, 4 days later, the patient had no pain in the heels or Achilles tendons, but some pain was present near the external ankle bone. This pain was more a stiffness and was different from the pain he felt before. The patient did not run between the second and third treatments, but he did some jumps during his training and felt no pain nor discomfort. Still some modifications were made to the treatment to adjust it to the current situation of the patient. With Achilles tendons and heel pain completely resolved, the patient was advised to not wait to make an appointment if the pain returned. The patient was able to race the following week and did not have to return for further treatments.
A large part of Sports Acupuncture Mtl’s clientele is made of runners and, just like plantar fasciitis, tendonitis of the Achilles tendon is a very common reason for consultation. The case presented above is a fairly typical case, although it is common for more treatments to be necessary.
If you suffer from heel or Achilles tendon pain, or any other sports injury, contact us to make an appointment or to learn more about what acupuncture can do for you.