Achilles tendinopathy is an unfortunately common complaint seen in our clinic. The pain is usually from damage and inflammation to the Achilles tendon. This may occur due to a single incident of overstretching or straining the tendon, or through general overuse where the tendon becomes worn and damaged.
Several factors can contribute to the development of Achilles Tendonitis.
- Wearing high-heeled shoes that shorten and tighten the calf muscle
- A sudden increase in the amount of training or walking
- Poor footwear that rub against the tendon or do not support the foot adequately
- Training on hard or uneven surfaces – beach running and running up hills is notorious for this
- Insufficient stretching or recovery between training sessions
- Poor foot biomechanics – excessive pronation is the most common
- Weight gain
Achilles symptoms include:
- Pain in the Achilles tendon, heel or lower calf
- Tenderness to pressure
- Redness and swelling are common
- Difficulty rising up onto your toes, particularly when standing on 1 leg only
- Pain when hopping
Early physiotherapy treatment for this problem is vital as it can become difficult to resolve the longer it has been there. Sticking to the full rehabilitation program is also important to achieve an optimum outcome and prevent reoccurrence.
Treatment may include:
- Correction of foot biomechanics – advice on footwear and/or the prescription of orthotics if needed
- Loosening of muscle and joint structures that may be impairing or altering normal movement of the calf muscles and ankle joint. This may include mobilizing or manipulating the bones of the ankle and the foot as well as stretching and releasing the muscles of the calf. .
- Dry needling to release overloaded tissue
- Strengthening program to prevent re-injury by progressively loading the tendon
A calf stretch through-out the day can help with reducing some tension in your calf muscles.
- Start standing on one leg on a stair or curb, with your heel hanging off the back.
- Gently press your heel toward the ground until you feel a gentle pull along the back of your lower leg.
- Hold for 30 seconds.
- Then slowly bend your knee slightly, until you feel the stretch move lower on the calf.
- Hold again for 30secs and repeat both sides.
Another great exercise to settle the pain if it is very low down near your heel, is by just going up onto your tippee toes – hanging on to the wall if needed! Hold this position for 30 secs and repeat 10x.
A tendon needs to be strengthened to improve its ability to store energy and take compressive loads. This exercise works really well if you pull up sore after training and also helps condition the Achilles tendon to prevent further damage. Have a try yourself!