Achilles Tendinopathy is a common overuse injury which comes on gradually, generally presenting as pain, swelling and stiffness in the back of the heel. It is often worse in the morning, or following prolonged periods of rest, and will improve as the tendon warms up. In the early stages pain will often completely disappear when running and when you are warm, but will then worsen once the tendon cools down.
The Achilles will be tender to touch and often you will be able to feel a lump in the area where the tendon is damaged. At times the tendon may feel “creaky”.
As the injury worsens the Achilles can be become painful with all activities, even walking and running will become nearly impossible without pain.
A number of factors can contribute in the development of Achilles injuries. These include over-training, poorly fitting footwear, poor running technique, training terrain and muscle imbalance. The constant overload causes a stress reaction in the tendon, resulting in structural changes which affect its ability to load and transfer energy during movements such as walking and running.
Initial Management Strategies
There are number of options to try initially to reduce pain in the Achilles region:
- Ice your Achilles to help reduce pain
- Rest your leg from exercise to allow the tendon to settle
- Put a heel raise in your shoe to take load off the achilles
- Change your training – incorporate more rest days or change running surfaces to take pressure off the tendon
- Check your shoes – seek help with the correct footwear for you. Bodysmart Health Centre recommends The Running Centre on Hay Street in West Perth for assistance with footwear selection
- Cross train – mix up your training. Add some low impact exercise into your routine. This can include cycling, swimming or walking
- Isometric exercises – static holds are associated with pain relief with tendon pain.
If you continue to have pain then it is time to seek further help with management.
Contrary to popular beliefs, Achilles Tendinopathy is not an inflammatory condition, and therefore is unlikely to respond to anti-inflammatory medication. Physiotherapy treatment can help identify the cause of your pain and what treatment options are available to you.
Treatment available to you at Bodysmart Health Centre includes:
- Assessment and identification of biomechanical factors that may be contributing to the injury.
- Running assessment – identification of poor running technique that may be overloading the tendon.
- Manual therapy including soft tissue release, acupuncture, joint mobilisation.
- Rehabilitation exercises – for the immediate area and surrounds, often includes core and pelvic stability exercises.
- Guided return to running.
It is important to realise that posterior heel pain will not always be caused by the Achilles tendon. There are a number of other possible causes, which can include plantarfasciosis, bursitis and inflammatory conditions such as Reiters Syndrome and Psoriatic Arthritis. If your symptoms are not resolving it is important to seek medical treatment through a Physiotherapist or General Practitioner to ensure the diagnosis is correct.
Achilles tendinopathy can be a frustrating and lengthy injury, getting the correct advice and treatment early can help reduce the time it takes to resolve. Be aware of your symptoms and seek treatment early to ensure you can continue with your training with as little interruption as possible.
Contact Bodysmart for a Physiotherapy consultation to thoroughly assess any aches or pains. Appointments can be booked here or by contacting 9481 8708.