Limping due to a painful, inflamed achilles tendon can cramp your lifestyle. A form of tendonitis, this issue affects the large tendon that connects your calf muscles to the back of your heel. For many, this pain can become persistent—and to make matters worse, it’s not easy to treat. Frustration builds when treatment brings short-term relief, only to flare up again once you resume normal activities. Fortunately, pain in this tendon can often be significantly relieved by looking at underlying causes in the connective tissue called fascia. 

Many achilles tendonitis cases occur due to repetitive stress from activities like running or jumping. However, most cases are not caused by a specific injury and seem to develop for no obvious reason. In my practice, I find that achilles tendon inflammation can be traced to restrictions in fascia, a fibrous tissue throughout the body.   

Structural Fabric 

Fascia covers your muscles and bones, connecting them to other tissues. This “structural fabric” holds special nerve endings that sense pressure and tension. When you move, these nerve endings send signals that tell the brain where each body part is located in space.  

The medical term for this is proprioception, which means “position sense.” This information allows you to maintain coordination, balance, joint alignment, and muscular stability. A fascia restriction or distortion in one area of the body can confuse those signals and affect another area, resulting in subtle weakness and instability of muscles and joints. In turn, this can lead to pain or injury, including problems like achilles tendonitis.  

No Beach Walks  

A patient, whom I will refer to as Stan, came into our office looking for help with tendonitis that had been causing him heel pain for years. While he could walk normally for short distances, he would start to limp after more than 10 minutes. The extra muscle challenge of walking on sand made beach walks with his wife out of the question.  

Physical therapy with ultrasound, stretching, and strength exercises helped relieve his acute pain flares, but no treatment had resolved the problem long-term. After hearing that my practice takes a whole-body approach to underlying causes, Stan came to us in search of an explanation—and solution—for this issue. 

Stan’s initial examination at our office showed restriction of the fascia near the achilles tendon and in the muscle just above. More importantly, there were tight restrictions in the fascia of certain hip and low back muscles that resulted in uneven muscle tension in the hip and thigh on his painful side. This instability was causing a deep tension in his calf muscle and excess stress on the Achilles tendon. Stan could stretch the calf for temporary relief, but the tension would not fully disappear because it was coming from another part of his body.   

Finding Relief 

Stan’s treatment protocol focused on hands-on therapy to release fascia restrictions in the low back and hip area, then eventually in the calf muscle. Low-level laser therapy was also applied to the achilles tendon itself to improve tissue health, decrease inflammation, and alleviate the pain.  After several weeks of treatment, he resumed two-mile walks around his neighborhood with only mild discomfort. By the time his treatment was finished, Stan could walk in the sand again and enjoy strolling the beach with his wife.  

Two keys led to Stan’s pain relief. The first was realizing that fascia restrictions had created the muscular imbalance and chronic pain. The second was looking beyond the painful area and assessing his entire body framework to locate the underlying root causes.  

No two cases of achilles tendonitis are exactly the same. However, I find that using this approach leads to a successful treatment almost every time.  This is true even in the cases of bone spurs, bony enlargement of the tendon attachment (Haglund’s deformity), or even scar tissue from surgical tendon repairs. Therapies that treat and release restriction from fascia can offer remarkable results for achilles tendinitis. I recommend that anyone suffering from this pain consider seeking out a practitioner who can evaluate you for potential restrictions in the fascia, then use a whole body treatment approach to resolve it.             

Eric Winder D.C. uses gentle manual therapy and rehab techniques to help patients with a wide range of pain and injury problems. Dr. Winder’s offices are located in Sarasota and Osprey.  For more information, call 941-957-8390 or visit https://gentlebay.com/