Case Study: Achilles Tendonitis From A Tilted Heel Bone

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In most cases, when your Achilles tendon hurts or is inflamed (Achilles tendonitis), it is usually a result of having tight calf muscles that strain the tendon, and not absorbing enough of the shock from the footfalls. But this is not always true as it was with a recent client of ours.

Client Background and Analysis

This client has had this pain for some time. Frequent massages in the past to his calf muscle did not provide relief. When the client came to see us for the first time, we ruled out tight calf muscles. So we started to look elsewhere for the cause of his pain. Upon closer questioning of his pain and examination of these lower limbs, it revealed a tilted heel bone.

How a tilted heel can lead to achilles tendonitis
How a tilted heel can lead to Achilles tendonitis

The pain at Achilles tendon was slightly more painful on one side than the other. This strongly suggested that the strain to his achilles tendon on more on one side. Something caused more load to pass through one side of his tendon than the other when his foot struck the ground. This explains why massages to his calf muscles did not provide the anticipated relief. A tight calf muscle would have had loaded the tendon evenly on both sides.

We found the heel bone of the affected foot to tilted slightly outward. Not enough to be noticed by an untrained eye but sufficient to cause uneven loading of the achilles tendon over time, and hence achilles tendonitis. Mobilisation of the heel joint to release the structures holding the heel in the tilted position returned the heel of its proper alignment. This provided immediate pain relief on asking the client to jump on the spot.


Further treatment plans include the application of rigid sports taping to hold the heel in place and gait analysis with orthotics to help prevent a recurrence.


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