Explanation of Diagnosis

Achilles tendonitis is inflammation of the Achilles tendon, which connects the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). It is typically caused by overuse, repetitive stress, or a sudden increase in activity. Symptoms include heel pain, stiffness (especially in the morning), swelling, and tenderness along the back of the ankle. If untreated, it can lead to chronic pain or an Achilles tendon tear (rupture).

Specific Work Modifications

• Avoid prolonged standing, walking, or climbing stairs.
• Use cushioned, supportive shoes or orthotic inserts to reduce tendon strain.
• Modify tasks by alternating between sitting and standing.
• Take frequent breaks to stretch and rest the foot.
• Avoid walking barefoot or in unsupportive footwear (e.g., flip-flops or high heels).

Specific Activity Modifications

• Avoid running, jumping, or high-impact activities (e.g., basketball, tennis, hiking on uneven terrain).
• Modify workouts by replacing running with cycling, swimming, or elliptical training.
• Use proper warm-up and stretching routines before exercise.
• Gradually return to activities with lower intensity and proper footwear.

Recommended Supplements

• Collagen peptides (10 g daily) – Supports tendon repair.
• Vitamin C (500 mg daily) – Aids collagen synthesis.
• Magnesium (300-400 mg daily) – Helps muscle relaxation and recovery.
• Turmeric (500 mg twice daily) – Natural anti-inflammatory.
• Omega-3 fatty acids (1000 mg daily) – Reduces tendon inflammation.

Recommended Nutrition and Hydration

Diet Recommendations:

• Anti-inflammatory foods: Fatty fish (salmon, sardines), berries, nuts, turmeric, and leafy greens.
• Collagen-boosting foods: Bone broth, citrus fruits, and bell peppers.
• Protein-rich foods: Chicken, eggs, lentils, and dairy to support tendon healing.
• Limit processed foods and excess sugar, which can worsen inflammation.

Hydration Tips:

• Drink at least 2–3 liters of water daily to maintain tendon hydration.
• Limit caffeine and alcohol, which can slow healing.

Home Exercise Prescription

Perform 2-3 times daily to reduce pain and improve flexibility:

1. Eccentric Heel Drops (Once pain allows)

1. • Stand on a step with your heels hanging off the edge.
   • Slowly lower your heels below step level over 3-5 seconds, then raise back up.
   • 10 reps, 2-3 times daily.

2. Calf Stretch (Straight & Bent Knee)

1. • Stand facing a wall, place hands on the wall, and step one foot back.
   • Keep the back leg straight for the gastrocnemius stretch.
   • Slightly bend the back knee for the soleus stretch.
   • Hold 20-30 seconds, repeat 3 times each leg.

3. Toe Towel Scrunches

1. • Place a towel on the floor and use your toes to scrunch it toward you.
   • 10 reps, 2 times daily.

4. Ankle Mobility Exercise

1. • Rotate the ankle in circular motions (clockwise and counterclockwise).
   • 10 reps each direction, 2 times daily.

5. Foam Rolling the Calf

1. • Use a foam roller under the calf muscle and gently roll back and forth.
   • 1-2 minutes per leg, 1-2 times daily.

Avoid high-impact or heavy-resistance exercises until pain resolves.

Helpful Books

1. "The Running Athlete’s Guide to Achilles Tendon Health" – Nicholas Romansky, DPM
2. "Rebuilding Milo: The Lifter’s Guide to Fixing Common Injuries and Building a Strong Foundation" – Aaron Horschig

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo with any questions. Always consult your physician prior to taking any supplements or medications.