What is Achilles Tendinopathy?

Achilles tendinopathy is when the Achilles tendon is irritated resulting in pain located just behind the ankle and below the calf. Attached to the calf, the Achilles tendon is the largest tendon of the body taking much of our bodyweight load when we are running, jumping, or even walking. Achilles tendinopathy commonly occurs in active individuals. The symptoms of pain and limitation in walking, running and jumping are often worse in the morning or after having cooled down. Longer term cases may begin to notice thickening of the tendon behind the heel.

Common causes:

The leading cause of Achilles tendinopathy is the excessive overuse of the tendon and is typically associated with sudden or unaccustomed loads. Without the minimum time for recovery, excessive and repetitive loads (beyond the capacity of the tendon) can lead to a tendinopathy. There is a subsquent reduction in tendon tissue quality and this lessens the tendons ability to resist the tensile forces generated by the calf and causes localised pain.

Management:

Initial treatment focuses on a combination of (i) reducing aggravation to allow sufficient time for tendon tissue healing and (ii) gradually increasing tendon capacity to improve the bodies ability to sustain repetitive activity in the future.

Intially reducing plyometric activity can be helpful to reduce aggravation (high energy activities such as bounding, jumping and running) – instead we focus on increasing tensile capacity slowly with less aggravating resistance exercises. A gradual and progressive exercise programme is key to allowing the tendon to adapt and improve capacity. The Sportsmed Mosgiel physio team can help provide appropriate programmes for improvement in symptoms and an eventual return to your chosen activity - painfree.

Other strategies include:

• Manual therapy techniques to reduce calf muscle tension and potential trigger points
• Reducing biomechanical load forces with targeted lower limb strength exercises
• Adjusting other modifiable factors such as appropriate footwear/orthotics
• If appropriate - reducing body mass

Prevention:

The key to prevention of Achilles tendinopathy is appropriate load management – training programmes need to be sufficiently gradual to allow bodily adaption and improvement in tendon capacity. This is particularly important when your are training toward a goal that involves increases in mileage or load.

If you are concerned that you may have an Achilles tendinopathy make an appointment with one of our highly experienced physiotherapists at Sportsmed Mosgiel Physiotherapy.