Further Outpatient Care
See the list below:
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The patient should return for re-evaluation every 4-6 weeks until the symptoms are resolved or under adequate control.
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These follow-up visits provide the clinician with an opportunity to monitor the efficacy of the treatment plan and to make appropriate modifications if the patient's symptoms have not adequately improved.
Deterrence
See the list below:
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The patient should avoid footwear that fits tightly at the posterior heel.
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High-heeled shoes should be avoided.
Complications
See the list below:
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Chronic or progressive posterior heel pain
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Limping (antalgic gait)
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Achilles tendon rupture occurring secondary to chronic inflammation or perhaps resulting from corticosteroid injection
Prognosis
See the list below:
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Most patients respond well to a combination of local icing, oral anti-inflammatory medications, Achilles tendon stretching, and footwear modification.
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Surgical intervention may provide good results for patients in whom conservative treatment has failed.
Patient Education
See the list below:
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The patient should be educated in the proper performance of Achilles tendon stretching.
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The patient should understand the rationale for appropriate footwear.
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A patient who is considering corticosteroid injection must understand the potential risks and benefits of this treatment.
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For patient education resources, see the Foot, Ankle, Knee, and Hip Center, as well as Bursitis.
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Achilles stretch 1; whole-person view. The patient stands with the affected foot flat on the floor and leans forward toward the wall until a gentle stretch is felt in the ipsilateral Achilles tendon. The stretch is maintained for 20-60 seconds and then is relaxed.
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Achilles stretch 1; cropped view showing a close-up of the region affected by this type of stretch.
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Achilles stretch 2; whole person view. This stretch, which is somewhat more advanced than that shown in Images 1-2, isolates the Achilles tendon. It is held for at least 20-30 seconds and then is relaxed.
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Achilles stretch 2; close-up view.
