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Understanding Achilles Tendinoapthy

Achilles tendionapthy is  a frustrating injury but very common. The Achilles tendon is a really important spring that propels you forward during walking, running or jumping.

It is a condition where the tendon (structure connecting muscle to bone) becomes painful and weakened due to excessive forces being placed on it.  Initially the Achilles tendon can be pretty sore for 14-21 days.

It is especially sore in the mornings on those first few steps. The pain is generally localised to the middle part of the Achilles tendon tendon and it can appear thickened. Sometimes without the right management an Achilles tendon injury can drag on for weeks, months and years.

A sudden increase in loading is usually the problem when tendinopathy develops. Overloading causes:

  • Intensity: increased speed, distance, frequency of training

  • Footwear: lower heel shoes or tight heel cup

  • Surface: soft surface x hard 

  • Long period of rest such as holidays, off season, injury

  • Poor running/movement technique

  • Asymmetric stability along the whole body kinetic chain

Expected recovery time

Due to poor blood supply, tendinopathy can take around 12 weeks to resolve. Recovery times are usually dictated by severity and length of time the injury has been present for.

How to manage it

  • Maintain fitness whilst offloading tendon, which means to stop all spring like activity for at least 4 weeks or until you have seen a Physio. That can include running, jumping and skipping.

  • Improve whole-body strength

  • Avoid any activities that cause pain levels greater than 2/10

  • Avoid stretching the area.

** Tendons are designed to take “load” or force. Increases in the amount of load a tendon can take should be incremental and slow to ensure the tendon is not overloaded. If increases in load occur too quickly, the tendon will again become aggravated.

Reccommended program

Recent research has found that doing isometric calf raises can really help settle your achilles tendon pain down. Isometric  calf raises are basically calf raises without moving up or down. You have to do them at around the mid point of the calf raise. If you raise up too high in the calf raise it can actually make you worse.

Do the below exercises 4 times per day initially for about 2 weeks. Progress from double leg to single leg as quickly as pain allows (no more than 2/10)

Isometric contraction for pain relief - double leg

• 40-60 seconds hold x 4 reps - 4 times/day

** Progress from double leg to single leg as quickly as pain allows, no more than 2/10

Isometric contraction for pain relief - single leg

• 40-60 seconds hold x 4 reps - 4 times/day

How can Physiotherapy help?

Physiotherapy plays a role in the diagnosis and finding out the underlying issues causing the tendon to be overleaded in the first place. With that information after a thorough assessment, we can help you with a long-term pain relief including:

  • Comprehensive assessment to identify the root cause of the problem, areas of weakness, technique error and poor mobility that caused injury

  • Temporary orthotic or taping may be required to off-load tendon (heel wedges, arch lift)

  • Individualised exercise program that target areas of weakness, technique error and poor mobility that caused injury.

  •  Manual therapy such as soft tissue massage, dry needling can be used to restore normal function and reduce pain

  • Education and self-management strategies: provide you with tools to manage your symptoms independently. This empowers you to take an active role in your recovery and prevent future recurrences.

Remember, finding the right treatment plan tailored to your specific needs is essential for long-lasting relief.

Don't let Achilles pain hold you back any longer – take the first step towards a pain-free life by consulting with Cibele today!

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