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Achilles Tendinopathy

Posted by CPSIC Physiotherapy , 26 May 2012 · 942 views

Sports Injury Prevention and Advice
Crystal Palace Physiotherapy and Sports Injury Centre

Sports injury blog...

Are you a runner, sports person or a regular walker??

Know your enemy! - Achilles Tendinopathy in a nutshell

The Achilles tendon is the large tendon at the back of the ankle. It connects the large calf muscles (Gastrocnemius and Soleus) to the heel bone (calcaneus) and provides the power in the push off phase of the both walking and running. The term Tendinopathy is descriptive of an often painful dysfunction of a tendon.

Acute Achilles Tendinopathy symptoms
  • Gradual onset of pain over a period of days
  • Pain at the onset of exercise which fades as the exercise progresses
  • Pain eases with rest
  • Tenderness on palpation
Should the acute form of this injury go untreated or if it is not allowed sufficient rest, a chronic (or longer form) of the injury may result. This can be a much more difficult condition to treat as the body changes its healing response due to repeated stresses on the injured tissue.
Where possible we advise our patients to take steps toward resolving the injury before this 'chronic' phase takes hold.
Chronic Achilles Tendinopathy symptoms
  • Gradual onset of pain (often starting as mild and manageable) over a period of weeks, or even months
  • Pain in the tendon when walking especially uphill or up stairs
  • Pain and stiffness in the Achilles tendon especially in the morning or after rest.
  • Longer periods of morning pain can indicate a progressive worsening of the condition
  • Palpable tender lumps in the Achilles tendon - typically mid way
  • A change in training routine e.g. an increase in mileage, change reducing recovery time between runs
  • Weak or tight calf muscles
  • Long periods of wearing high heels may lead to a progressive shortening of the calf muscles.
  • Ankle joint stiffness (possibly due to a previous ankle injury)
  • Over pronation (rolling in of the foot) during running can increase load on the Achilles tendon
What can you do?
  • Rest! In the early stages, reducing the amount of runs per week may suffice, but if the condition persists it may be required to lay off running fully until symptoms have begun to resolve. Like any inflammatory condition 10-15 minute periods of icing after a run can help to reduce pain and improve function.
  • Stretch and strengthening the calf muscles improving the function of the region. In particular calf strengthening exercises containing an eccentric (lengthening) component have been proven to be superior to other forms of rehabilitation.
  • Ensure you perform an appropriate warm up and cool down when training.
  • Ensure your running shoes are the correct model for you (and still doing their job! - it’s amazing how often we see people in the clinic who are wearing either the wrong type of shoe or shoes well past their use-by date!)
  • If symptoms persist you may benefit from visiting a Sports Physiotherapist who can assess and identify the cause of the overloaded Achilles and advice on treatment including flexibility and strength work of the calf muscles and Achilles itself, soft tissue release and review of running technique.
  • Sports Massage can be useful both to prevent calf tightness and overloading the Achilles as well as relieve symptoms that have appeared seeing a Podiatrist for a review of additional causes such as foot biomechanics and running technique analysis has also been shown to assist in management of this condition.
Did you know?
It is estimated that Achilles Tendinopathy accounts for around 11% of all running injuries.


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