In this week’s blog we are going to look into Achilles tendinopathy. The reason is that it links quite closely to our earlier topic of plantar fasciitis, and the as the weather warms up and we start to engage in more outdoor activities, we tend to see more of these cases coming through the clinic.
The Achilles is the big thick tendon at the back of the ankle that joins our calf muscles to our heel. It plays a big role in walking, running, hopping, skipping and jumping and because of this it’s also prone to getting overloaded.
Achilles tendinopathy is essentially an over use injury caused by repetitive loading on the tendon. This causes tiny micro tears within the tendon, which produces an inflammatory response as the body attempts to heal the damaged tissue.
Because the loading through this area is fairly constant, due to the amount of time we spend on our feet, the inflammation fails to repair the damaged tissue and instead more inflammation is laid down, leading to a repetitive cycle of inflammation and pain. This can lead to weakening of the tendon and, in severe cases, complete rupture.
What does it feel like? There can be many different presentations but the most common is tightness and pain when the tendon is cool (i.e. first thing in the AM, start of exercise), that eases as it warms up (walk around for a bit, middle of exercise session) and then aches afterward. The pain is more common on the inside of the Achilles (due to our foot posture) and you can quite often feel small nodules through the area. It is most easily elicited if you pinch the area between a thumb and forefinger.
Common causes of Achilles tendinopathy include over-training or unaccustomed training load (too much too soon), pronated or flat feet, wearing unsupportive footwear, tight hamstring and calf muscles, or insufficient healing time following an acute injury to the calf or Achilles.
So can Achilles tendinopathy be treated? Absolutely! The key to it and any tendinopathy, tendonitis or tendinosis is unloading the tendon. If you don’t unload it, it won’t get better. It’s that simple. This doesn’t necessarily mean you have to stop activity, though in many cases you will need to for a period of time until pain eases, but it does mean you need to find out why and how the tendon is being overloaded (that’s where we come in.)
Common treatment includes pain reduction through ultrasound and unloading taping, release to the calf muscles and joints of the ankle, foot posture correction through taping initially and then a footwear assessment, followed by a specific and targeted eccentric strengthening program, which you may have seen an example of in some of our facebook video’s.
We believe that prevention is better than cure so here are a couple of tips to help minimise the chance of Achilles problems occurring in the first place:
1. Invest in and use a pair of good, supportive shoes at all times.
2. Ease into your training routine, increasing by, not more, than 10% per session
3. Engage in a good stretching routine, before and after exercise.
If you do feel any of the symptoms we outlined above then consult your healthcare practitioner sooner rather than later.
So there you have it, that’s a brief run down on Achilles tendinopathy. If you have questions or comments feel free to e-mail us at firstname.lastname@example.org and we will happily answer them for you.
If you think you may already be suffering from Achilles tendinopathy and want relief now then call us on (08) 9486 8653 and we will arrange an appointment for you.