Overview
Tendons are strong fibres that connect muscle to bone. Your Achilles tendon is the structure that connects your calf muscles to your heel bone and is one of the strongest tendons in the human body. The Achilles tendon can resist large amounts of forces when running and jumping. The main reason we now refer to it as an tendinopathy instead of tendinitis is that “itis” refers to inflammation and Achilles tendon pain does not always involve inflammation of the tendon.
What is Achilles tendinopathy?
It’s an overuse injury of the Achilles tendon caused by either repetitive or intense strain on the tendon when walking, running, jumping and stair climbing activities. This causes repeated tiny injuries (known as microtrauma) along the Achilles tendon with the ingrowth of sensitive nerves and abnormal tendon cell structure.
What are Symptoms of Achilles tendinopathy:
- Pain along the tendon or back of the heel that may worsen with activity
- Worse pain after exercising
- Morning tenderness or stiffness
- You may experience swelling or a thickened lump on your Achilles.
Risk factors:
- Rapid change in exercise intensity or duration.
- Over training
- Calf muscles weakness and/or tightness.
- Stiff ankle joint.
- Poor motor control at hip and knee.
- Flat feet
- Footwear: running in worn-out shoes or shoe without adequate arch support.
- Gender: males > females
- Age: >30 years old more common.
- High blood pressure.
- Overweight
- Type 2 diabetes can negatively affect tendon health.
Management:
A physiotherapist will provide a thorough physical examination which includes special testing, strength testing, functional measures and questionnaires for outcomes measures to track your progression and severity.
Achilles tendinopathy can be successfully managed conservatively (without invasive procedures like surgery) and may take up to 3-6 months for symptoms to completely reside. Achilles tendinopathies are best managed through activity modification, progressive tendon loading programs, soft tissue/manual therapy techniques, stretching, orthotics/footwear, taping techniques and other adjunct therapies such as Shockwave therapy for chronic cases. Your Physio will help devise the most appropriate management program to help get you back to full function according to your unique circumstances.
You can also consult your treating Doctor for appropriate anti-inflammatories which can also provide short-term pain relief. In most cases imaging is not required for diagnosis or best management, in some cases imaging may be recommended.
Written byL Lewis Campbell.
