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Achilles tendinopathy - what is it?

posted Nov 13, 2016, 3:14 PM by Rebecca Smith
Other than being associated with Greek mythology and the weak point of the body, the Achilles is the large tendon that sits behind your ankle and attaches the calf muscles to the heel. Due to the tendon being large and responsible for high load activities (including walking, running, jumping etc.), the Achilles tendon takes on a lot of tension on a regular basis especially for those who are active and involved in sports. While some people’s Achilles tendons can manage these tasks without any issues, other people’s Achilles tendons can go through a process of wear and tear (microtraumas) which can lead to tendinopathy. 

Achilles tendinopathy is made up of 2 types of conditions, which are tendinosis and tendinitis. Tendinosis describes the tendon going through a process of degeneration, while tendinitis describes the inflammation of the tendon. Due to the similar nature of both conditions and the fact that they are treated very similarly, the term "Achilles tendinopathy" is used. 

Specific causes of Achilles tendinopathy can include overuse (e.g. playing too much sports), inappropriate footwear, poor walking/running technique, tightness of the calf muscles/tendon, and weakness of the calf muscles/tendon. Generally speaking, Achilles tendinopathy occurs when a load from a specific activity consistently exceeds the tendon’s load-tolerance. 

Initial management of an Achilles tendinopathy includes rest, ice pack (especially if inflammation is involved) and taking anti-inflammatories. This aims to allow the tendon some time to recover and prevent further damage from taking place. Once the pain has settled a bit, your physiotherapist will continue with other treatments to further reduce pain in the Achilles tendon. 

If tightness of the calf muscles are present, your physio will provide massage to the calf, as well as teach you some stretches and foam roller exercises. In the case of poor footwear and poor walking/running technique, orthotics may be recommended along with exercises designed to improve your walking/running technique. A referral to a podiatrist may also be advised especially if custom-made orthotics are necessary. 

Strengthening exercises are also provided in the management of Achilles tendinopathies. Strengthening the muscles allows the load-tolerance of the Achilles tendon to improve so that usual activities that may cause pain, such as running, don’t end up causing pain (or cause less pain). This is the same principle behind plyometric exercises (such as jumping and hopping) except these are introduced later on, due to these exercises producing a higher load on the tendon. 

Other treatments that may be utilised include dry needling and shockwave therapy. 

Your physio will continue working with you until you can manage all of your usual activities with minimal to no pain, where they will set you up on an independent management plan in order to prevent it from occurring again in the future. 

If you have been suffering with Achilles pain, then book yourself an appointment with any of our team. 


Robert
Physiotherapist Narellan
Difference Physiotherapy Narellan & Camden
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