Achilles tendon pathologies can either be due to an acute injury, mostly occurring in relation to sports, or have a chronic background and are called tendinopathies. Achilles tendinopathy is one of the most frequent tendon pathologies caused by overuse or overload stresses, which lead to repetitive micro-trauma. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855626/#:~:text=Achilles%20tendon%20pathologies%20can%20either,micro%2Dtraumata%20%5B1%5D.
What is Achilles Tendinopathy?
Achilles tendinopathy is occurrence of pain, swelling and stiffness of the Achilles tendon. The Achilles tendon is the band that joins the calf muscles to the heel bone. Pathology to the tendon can cause discomfort and limit freedom of movement. https://patient.info/foot-care/heel-and-foot-pain-plantar-fasciitis/achilles-tendinopathy.
What are the causes of Tendinopathy?
The most common cause for the occurrence of an Achilles tendinopathy is from overuse and overloading of the tendon. When the tendon is unable to adapt to the load placed on it, pathology can occur due to the repetitive micro trauma placed on the area and the tendon attempting to adapt and heel itself. Other terms for the same occurrence that people may use to describe tendinopathy are: Tendonitis or Tendonosis https://www.ouh.nhs.uk/patient-guide/leaflets/files/11924Ptendinopathy.pdf.
Overloading of the tendon can occur in one specific incidence, alternatively it can be an accumulative effect over time. Factors that can influence load, for a runner for example are: increased volume or intensity, a change in the running shoes as well as a sudden change in the running terrain.
What are the symptoms of Achilles tendinopathy?
– Pain and stiffness around the area by the back of the ankle, as a result of where the tendon is located
– Thickening of the tendon, thereby resulting in decreased activity function
– Tenderness locally at the area of the tendon, usually from the discomfort and inflammation to the area
– Pain during or after exercise, however one will usually feel more symptomatic the morning after exercise
– Commonly there is a warm up phenomena, whereby athletes experience the pain decreases after a warm-up, thus allowing them to continue through the exercise. When this occurs, the pain will unfortunately usually return on the stopping of the exercise or the cool down.
– A very common feature of achiles tendinopathy is the presence of morning stiffness/ pain on waking
Physiotherapy management of Achilles Tendinopathy
There are several ways in which a Physio can assist with the diagnosis, treatment and management of Achilles Tendinopathy. Contact us should you want to understand more about how we can assist in Sunninghill with the management or to gain further insight.https://www.laraphysio.com/contact-us/.
Exercise prescription by your physiotherapist, as well as rehab programs are a very important way in which we treat this condition. Loading the tendon accurately is key to improving on the symptoms. To manage load we will decrease the current load to control and settle the symptoms. Following this we will gradually progress the load placed on the tendon to improve its ability to withstand the forces placed on it. https://www.healthlinkbc.ca/health-topics/tr2261#:~:text=For%20Achilles%20tendinopathy%2C%20physiotherapy%20can,and%20help%20the%20tendon%20heal.
Deep massage and shock wave therapy treatments can also assist in the healing process and improved blood flow to the area.