Achilles Tendinopathy

What is the Achilles Tendon?

The Achilles Tendon can be found just above your heel on the back of your leg. A tendons job is to join your muscles to your bones. The Achilles tendon joins your heel bone to your calf muscles. Its function is to bend the ankle downwards or in other words, go up on your tip-toes. 

What is Achilles Tendonopathy? 

Achilles Tendinopathy is a condition that can cause pain, swelling and stiffness of the Achilles tendon. You may often hear these injuries be called tendinitis or tendinosis but these terms are all commonly used to describe the same condition. A tendonopathy can occur with any of the tendons in your body and we know this occurs when the tendon is unable to adapt to the strain or the load being placed upon it. Achilles tendonopathy can be considered a rather common injury and can affect both athletes and non-athletes alike. It is however more common in athletes who partake in sports that require a lot of running and jumping such as Gaelic football, Hurling, soccer, basketball and both short and long-distance running. It affects both men and women, young and old but is more common in men and in people aged 30 or more. 

What Causes Achilles Tendonopathy? 

•         Overuse of the Achilles Tendon, especially in athletes who run and jump regularly as part of their sport.
•         Having poor technique in your training (e.g. poor biomechanics when running)
•         A sudden change in your exercise regime, eg, a sudden increase in volume or intensity of training or even a change in surface.

Other things that may put you at a higher risk of developing this condition are

•         Higher BMI
•         Tight and or weak calf muscles.
•         Poor strength endurance of the calf muscles.
•         Poor knee stability.
•         If you have diabetes, your chance of developing Achilles tendinopathy will increase.
•         Lack of variation in training,
•         Old or poor-quality footwear when running. 

How to recognise the signs and symptoms of Achilles tendinopathy. 

Below are some common signs and symptoms that people with Achilles tendinopathy may experience.

•         Stiffness in the morning. people may complain of stiffness and pain around the tendon first thing in the morning, this can ease once you get walking about or can even last a bit longer in more severe cases.
•         Gradual onset pain: Pain is often very minor in the beginning; it often gradually worsens over time.
•         Pain after exercise: Some people experience pain during exercise but in general pain will be worse after exercise. Athletes often feel they notice the pain at the start of their exercise, it tends to ease during the session and when they stop running again, the pain levels increase.
•         Tender to touch: Often times the Achilles tendon will be very tender when you touch the general area. Swelling also can appear in the area.

What to do about it? 

The first thing you should do if you suspect you may be suffering from Achilles Tendinopathy is visit a Chartered Physiotherapist. We will provide an accurate diagnosis of your condition, an estimated recovery time frame and also, they will create a tailored exercise programme to accelerate rehabilitation timeframes. Time, rest and load management of the tendon are among a few things that will help alleviate symptoms in the early stage. The use of ice and anti-inflammatories are highly recommended.

Your physiotherapist may look at a number of hands-on treatment options depending on your presentation, some of these include

•         Tendon loading management techniques
•         Dry Needling
•         Desensitisation of surrounding tissues via soft tissue release
•         Modalities such as Shockwave Therapy.
•         Joint Mobilisation.

Most importantly your physio will design a specific exercise programme that will be tailored to your needs. This programme will be progressed each time you see your physiotherapist to ensure you are placing optimal load on the tendon. Exercise is seen as the gold standard for treating this condition and combined with some of the techniques above.

Unfortunately, there is no quick fix for this condition and it won’t heal overnight, a reduction in morning stiffness/pain is usually one of the first symptoms to relieve. It is also important to note that during your exercise programme you may experience pain, this should reduce as you progress through your rehabilitation. We would recommend that a level of pain not exceed 4/10 when doing the exercises. 

Mark Hughes

Chartered Physiotherapist

Galway Bay Physio

Should you need help with any aches, pains or injuries you may be experiencing, you can book in online with any of our Chartered Physiotherapists galwaybayphysio.ie

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