Q: I am a 50-year-old runner who has had pain in my Achilles tendon for about six months. It bothers me at the start of a run and continues to improve until after I am done, when I experience severe pain and stiffness. My Achilles tendon also bothers me a lot when I first wake up in the morning. I have taken ibuprofen and rested from running, however, I am still not better. My friend suggested that I should get a cortisone shot in my Achilles. What is your opinion and who should I consult?
A: Achilles tendon inflammation, “tendinitis,” is a very common condition in athletes, particularly in men between the ages of 35 and 50. There are three large calf muscles that converge to form the Achilles tendon that attaches to the back of the heel and allows the ankle to flex. The tendon, when injured, is very slow to heal as it has a poor micro circulation. Treatment is geared at decreasing pain, swelling and stiffness, while restoring normal range of motion and strength.
Initial treatments include anti-inflammatory medications, physical therapy, flexibility exercises, night splinting and an “air heel” brace. Cortisone shots in the tendon are usually contraindicated as they may increase the risk of a complete tendon tear tenfold. I recommend you see an orthopedic surgeon or foot specialist to confirm your diagnosis and begin treatment so you can resume your normal lifestyle.