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Why do you have pain in the back of your heel?  Mariola Rivera, DPM

Achilles Tendinitis with 'bone spur'

Achilles tendinitis and retrocalcaneal bursitis are 20 % of Americans pain in the posterior aspect of the foot. Causes are overuse injuries, biomechanics abnormalities, foot gear, congenital deformities.


At Aesthetic Podiatry and Sports Medicine Center, our facilities offer treatments to treat conservative and surgical this common injuries in our population.

The early you treat this injury the faster it heals. Understand that your decision on treatment impact your care.


Initially, a patient with posterior heel pain, received full Radiograph evaluation. Dr. Mariola Rivera is an expect on analyzing the abnormal changes leading to the injury.

The most common injuries are insertional tendinitis, retrocalcaneal bursitis, posterior heel spurs and micro tears in the Achilles tendons.

Achilles tendon injuries are found in athletic and non-athletic patients. The treatment strategies would be adapt to your specific injury.

In our offices as conservative measures we initially offer RICE therapy, simple as rest, ice, compression, elevation. Some patients benefit from short term the use of nonsteroidal anti- inflammatory drugs. We also offer treatment options for those of you that can not take NSAIDS., such as Ibuprofen.


If you have treated all this measures before you come in to our facilities, we can offer you conservative approaches and surgical.

Normally, the most common cause of tendinosis and tendinopathy are biomechanics abnormalities in your gait. Some patients benefit from custom made foot orthosis to accommodate and correct abnormal gait. In our offices we offer the most modern techniques of casting approaches for our orthotics as well as 3D print devices.


Many people have to realize that most injuries are secondary to lack of strengthening of the posterior muscle group of the length. We train our patients to change their lifestyles including stretching as part of their daily activities. Most patients need assistant from a Physical therapist as conservative approach.

Initially, we evaluate the tendon fibers either by Ultrasound or MRI imaging. Those modalities are able to detect Achilles pathology, including calcified tissue, bone spurs, tears  or lack of vascular tissue.


Our offices in Westchester, New York are fully equipped with the most advance conservative techniques to provide fast recovery of your Achilles Tendon injury. We offered Electroshockwave therapy treatments, MLS laser, amniotic membrane injections and platelet rich plasma injections.


Electroshockwave therapy (ESWT) is considered a treatment for treating insertional Achilles tendon tendinitis before surgery. We had found similar good results in both our active sports patients and non-active sedentary patients. Normally, we suggest an average of  5 sessions of the electroshockwave. We advise our patients to avoid NSAID ( non-steroidal anti-inflammatories as for example Ibuprofen, Naprosyn) the day off and couple of days after. The ESWT works stimulating blood flow and breaking unhealthy tissue around the tendon fibers.


MLS laser is a Multiwave  Locked system, class IV FDA cleared device that helps relieve pain, and inflammation around the tendon fibers. Our office offers the newest laser machine that penetrates deeply into nerves and surrounding tissues. If you have Achilles Tendinitis around New York area you can benefit from MLS laser treatments. New injuries normally benefits from 6 sessions and old or chronic injuries from 10-12 sessions. The MLS laser is a minimally invasive, safe and pain free treatment modality to accelerate healing.


Platelet Rich plasma (PRP)  and amniotic membrane (stem cells )injections are use in our offices not only for Achilles Tendon injuries but also for plantar fasciitis, posterior tibial tendinitis, peroneal tendinitis, strains  and more.

The procedure is an outpatient procedure or can be added to your surgery.

PRP injections provide a use of platelet derived growth factors stimulus in regenerating tendon healing.  We have seen success on patients with over three months of exercise related pain and tenderness on palpation and shoe gear.


Percutaneous tendon debridement is a minimally invasive technique that we can debride unhealthy tissue and remove calcify tendon and bone


Open surgical repair of Achilles tendon requires de-attachment of the achilles from the calcaneus or heel bone for removal of bone fragment. This procedure requires re-attachment of the Achilles Tendon to the bone via bone anchors. Sometimes when conservative or less invasive techniques failed this is the surgical approach. Recovery could be 3 to 6 months.


If you have pain in the back of your heel call our office to schedule your initial evaluation and determine the best treatment options.

Dr. Mariola Rivera is a podiatric surgeon with an expertise in foot deformities. Mariola Rivera, DPM

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