Achilles Tendinopathy

Where and what is the Achilles Tendon?

The Achilles tendon is a large tendon at the back of the lower leg, just above the heel bone. It attaches the two calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). Its function is to "push off" during walking and running and enable us to rise up onto our tiptoes.

What is Achilles Tendinopathy?

Achilles tendinopathy is an overuse injury usually as a result of excessive loading of the Achilles Tendon.  It is a chronic condition where the excessive loads cause multiple small tears in the tendon. This may result in pain and weakness when the tendon is loaded but usually not at rest.

Previously Achilles Tendinopathy was also referred to as Achilles Tendinitis. However recent research has found that this type of injury due not involve any inflammation.

What are the symptoms of Achilles Tendinopathy?

• Pain around the Achilles tendon

• Ankle stiffness which is usually worse in the morning or at the start of an exercise session

• Pain with loading activities such as running and jumping

• Swelling around the Achilles tendon

• Tenderness to the Achilles tendon

• Calf weakness

What causes Achilles Tendinopathy?

This condition is commonly seen in participants of sports and recreational activities that involve a lot of running and/or repetitive jumping. It is usually caused by an acute change in load or activity. This change may be due to a sudden increase in training loads in athletes or beginning an exercise program for sedentary individuals.

General risk factors:

• Age: most common in those aged over 30

• Gender: more common in males than females

• Weight: more common in people with a higher than average body weight

• Diabetes: increased risk of the injury in people diagnosed with diabetes

Other factors that may cause this condition include:

• Over-training or a sudden increase in intensity, frequency or duration of activity

  

• Insufficient recovery time between activity

• Poorly supportive footwear

• Change in training surface and/or training on hard or uneven surfaces

• Reduced muscle flexibility

• Poor biomechanics/technique

• Reduced joint range of motion e.g. stiff ankle

• Inadequate warm up, cool down and stretching program

How is it diagnosed?

Your physiotherapist will be able to diagnose Achilles tendinopathy based on your clinical history, symptoms and a physical examination. They may ask you to perform some tests including a single leg calf raise or hop to assess your tendon's load response. Diagnostic imaging such as MRI or Ultrasound is not usually necessary.

How is it treated?

Initial management of Achilles Tendinopathy will focus on reducing your pain.

This may include:

• Ice packs

• Rest from aggravating activities

• Pain relief

• Gentle stretching exercises

Once your initial pain has settled your physiotherapist with prescribe a program likely to consist of:

• Eccentric Strengthening Exercises

  

  • These exercises are very important for tendinopathy rehabilitation. These exercises are designed to gradually increase the load through your tendon in a controlled way.

• Stretching exercises

• Massage

• Physiotherapy modalities such as ultrasound, laser or electrotherapy

• Acupuncture or dry needling

• Taping, bracing or orthotics

• Correction of poor biomechanics

An Achilles Tendinopathy injury may take weeks or months to heal. It is likely to take around 12 weeks to return to sport however everyone is different. Your prognosis should be discussed with your physiotherapist. It is important that your rehabilitation is closely monitored to avoid re-injury.

If you have any questions about Achilles tendinopathy, please feel free to contact us:

Phone: 9553 8145
Website: www.eqphysio.com.au
Or if you're in the area, drop on by and have a chat with us to see if we can help in any way. We're located at 1/45 Montgomery St, Kogarah NSW 2217.