What is ACHILLES TENDINOPATHY?
The Achilles tendon is a large tendon that runs down the back of the leg that attaches the calf muscles to the heel bone. The Achilles tendon gives the calf muscles the ability to push off during walking and running.
Achilles Tendinopathy is a condition that causes pain, swelling, stiffness and weakness of the Achilles tendon. It is commonly an overuse injury and is common in runners and athletes who train heavily or those that require a lot of jumping movements such as ballet dancers. It can also occur in people who are less active.
The pain can vary from mild to severe and is often described as a shooting pain, burning pain or even an intense piercing pain in the back of the heel. The pain can be aggravated by activities that repeatedly stress the tendon, causing inflammation or pain in the first few steps of the morning or after sitting down for extended periods of time which gets better with mild activity.
The two most common injuries of the Achilles are tendinopathy and rupture and this is due to excessive loading of the Achilles. Overloading can occur due to one or many of the following:
- An increase in activity (frequency, intensity and or duration) of activity A decrease in recovery time between activity
- Unsupportive or very flat footwear
- Excessive pronation
- Running on hard or uneven surfaces
- Tight or weak calf muscles
- Stiff ankle joint - reduced range of motion at the ankle joint Inadequate warm up or cool down
The immediate treatment of any soft tissue injury consists of the RICER protcol - rest, ice, compression, elevation and referral.
RICE protocol should be followed for 48 - 72 hours. The aim is to reduce the bleeding and damage within the joint.
The No HARM protocol should also be applied - no heat, no alcohol, no running or activity, and no massage. This will ensure decreased bleeding and swelling in the injured area.
Treatment includes rest, pain relief, stretching exercises, and changes in sports techniques and footwear to reduce stress on the tendon. Surgery may also be required in some instances.
Treatment and Rehabilitation of Achilles Tendinopathy by your Podiatrist
Achilles Tendinopathy can take weeks to months of rest for the tendon to slowly heal. Unfortunately blood supply to the tendon is not strong, therefore rehabilitation is a long process.
Once pain has settled, exercises and stretches may be prescribed to strengthen the tendon to cope with the load and return to activity.
Other treatments may include ultrasound therapy, mobilisation, stretching, massage and orthotics. Anti-inflammatory medication may also be indicated. A completely ruptured Achilles is most often repaired surgically. Return to activity must be gradual and this is usually aided with heel raises and taping.