Achilles Tendinopathy
What is it?
The Achilles tendon is formed through two calf muscles, called the Gastrocnemius and the Soleus, and attached at the bottom of your foot near your heel bone. It is one of the strongest and thickest tendons in your body and is tasked with the responsibility of handling 4-8x our body weight with each step we take.
Achilles Tendinopathy is the formal diagnosis for persistent tendon pain and loss of function related to mechanical loading. (Scott et al 2020)
Pain in the achilles tendon can be located in a few different places, most frequently being near your heel bone (insertion tendinopathy) or in the middle of the achilles tendon (mid-portion achilles tendinopathy).
Source: https://e3rehab.com/
What causes it?
The majority of the time that someone has any sort of tendon injury, it comes down to the fact the load on the tendon exceeded the capacity of the tendon. In simpler terms, you did more activity than that part of the body was capable of handling.
Frequent causes are increase in running/walking volume, change of shoe or surface, and basically doing too much too soon without adequate strength or endurance for the achilles tendon.
What can I do?
One of the first things to do would be to consult with a Physical Therapist to help identify and modify the aggravating activities. Rest and anti-inflammatories will not be the answer to managing your tendon pains. Your PT will help guide you to understand your pain and know when you’ve pushed too far or too little.
Stretching may not be the best for you, and in fact tends to lead to more pain as people get far too aggressive with stretching.
Once the primary aggravating factor is identified, your PT will help you build the capacity through mobility and strengthening the entire lower leg and improve any faulty movement patterns.
As you begin to tolerate the strengthening phase, you will gradually progress back into activities called low extensive plyometrics— fancy term for retraining your body how to handle impact. These are essential to help build tolerance to get back to running, jumping and playing sports. This is such an important phase to have professional guidance in because it can easily be overdone and force you to take a few steps back in your progress.
After a few weeks of dedicated strengthening and lower level plyometrics to improve tissue capacity, it is time to progress to the fun phase of sports, jumping and more dynamic activities.
How would Physical Therapy help me?
Overall, Physical therapy would help you to understand when it’s okay to be in pain, when you have done too much or too little, and help to safely guide you back to the activities you want to be able to do without pain.
Some treatment strategies you might see in Physical therapy include:
Education— this is probably the most important thing as we have highlighted above.
dry needling and soft tissue mobilization—to help reduce tightness/pain
Blood flow restriction therapy—to help improve strength without causing too much mechanical stress on the tendon and ankle joints
Strength training— to progress strength of the Achilles tendon to be able to handle the impact of whatever activity you are returning to
Running or gait analysis— this may include getting on a treadmill and having a PT record your running gait to assess for faults that may increase tendon stress.
If you or someone you know is struggling to manage their achilles pain, have them reach out to us at 512-481-2777 or info@athletesedgephysicaltherapy.com to get back on track today.