Achilles Tendinopathy / Tendonitis Injury & Treatment IN MELBOURNE
The Achilles tendon is the longest tendon in the body, connecting the heel bone to the calf muscles. Its role is to absorb and transfer high energy loads in a stretch shortening cycle from the ankle into the calf.
Think of the Achilles like a spring, storing energy and then releasing it whilst we walk and run!
Achilles tendinopathy is a condition where pain and stiffness is experienced at the site of the Achilles tendon.
There are two main types of Achilles tendinopathy. Tendinopathy in the middle of the Achilles tendon is called mid-portion Achilles tendinopathy, and the other is insertional tendinopathy where the Achilles tendon inserts into the ankle bone (calcaneus).
People usually report that symptoms gradually increase over time leading to an increase in pain and stiffness in the Achilles, particularly in the morning.
Pain usually settles during training or activity only to return while resting afterwards, or most commonly the next morning.
This increase in symptoms usually coincides with an increase in training load, from either increasing the amount of work done by an individual or by altering factors such as surface or shoe wear to increase relative load on the body.
Risk factors for Achilles tendinopathy
Age: >30 years
Gender: Men > Women
High blood pressure
Rapid change in load and exercise levels
Type II diabetes
Prolonged steroid use
Family history of tendinopathy
PAIN RELATING TO THE ACHILLES TENDON CAN BE HIGHLY VARIED.
For example, symptoms can slowly build up or occur suddenly. This can range from a minor inconvenience to extreme pain, and can last from days to years, which can again vary from being mildly disabling to a major impact on somebody's life.
That is why it is important to see a physiotherapist to accurately diagnose and to rule out other potential diagnoses.
Additionally, the time that someone has been dealing with Achilles tendinopathy usually reflects how long it will take to heal; someone who has been experiencing pain for a short amount of time will usually recover more quickly than someone who has been experiencing symptoms for longer.
Interestingly, some patients present with very tender pain to touch the tendon, as well as loss of function, whereas other patients have a loss of function, without any actual pain to touch.
This can be very confusing for patients, though a good therapist will utilise all their diagnostic tests to give you a firm diagnosis and prognosis, whilst ruling out other possible causes of your heel pain, including the lower back.
TREATMENT OF ACHILLES TENDINOPATHY & ACHILLES PHYSIO IN MELBOURNE
Treatment of Achilles tendinopathy usually includes exercise, soft tissue work, biomechanical correction and advice on loading programs and return to sport.
Treatment for Achilles tendonitis often dictated by the site of tendinopathy therefore it is important to review with your physiotherapist to ensure that treatment is tailored to you.
Be mindful of the advice or information you take in, as there are a lot of Achilles Tendon Myths that exist.
Relative Rest For Achilles Tendinopathy
Initially, resting, using ice pack and pain relief will reduce pain, swelling and stiffness of the Achilles tendon.
Resting your Achilles will often have short term relief of pain, however as soon as you return to running or sport, the pain often returns. The Achilles tendon does not have the capacity to take on the extra load and so becomes painful again. Complete rest can often make the problem worse.
Achilles Tendonitis Treatment Exercises
Your Achilles physio will identify which phase of injury you are in and recommend appropriate exercises to rehabilitate. It is important to feel a heavy load within the tendon when performing exercises and allow adequate time between sessions to recover.
Managing your load with Achilles tendinopathy
When managing you load, you should be guided by how your tendon responds immediately and 24 hours after exercise. Achilles tendons can have a latent response to load, meaning they can take a while to respond to exercise you did yesterday.
Using the traffic light system to determine how much training is too much is a perfect tool for athletes. Red indicates you must reduce your training load. Amber suggests the current exercise level. Green indicates that it is safe to increase your load.
Extracorporeal shock wave therapy for Achilles tendinopathy
There is some evidence for shock wave therapy when tendon pain is chronic, especially if other treatments have failed. Speak to one of the Achilles physio at Melbourne Sports Physiotherapy to see if shock wave therapy is right for you.
Unfortunately tendons can takes weeks or months to fully settle. Remember tendons do not like change, so it takes time to build them up to tolerate high physical activity levels! However, long term prognosis is often good if a strong and detailed exercise rehab program is prescribed. That means you can fix your problem with the right help!
At Melbourne Sports Physiotherapy our physiotherapists can help identify which activities have caused your Achilles tendon pain and devise a treatment program to decrease pain and return you back to the activities you enjoy pain free.
If you suspect you have an Achilles tendinopathy or have been told you have an Achilles tendinitis/tendinosis, make the smart decision and book in for an assessment to delve into your symptoms, and get a solution to your Achilles problems.