The Achilles tendon is just above your heel. It connects your calf muscle to your foot. When you are on your feet, it works like an elastic spring to store and release energy and helps to generate power. Achilles tendinopathy (also called tendinitis) refers to an overuse injury of this tendon. It is caused by a change or increase in load, particularly high and fast loads that place increased strain on the tendon, for example hopping, jumping and running, or possibly just a missed step.
It is a common injury in runners and people that participate in running and change of direction sports. However, it can affect anyone at any age who has had a change in their activity, even an increase in walking.
Symptoms include pain that is localised to the tendon and aggravated by load, for example pain with walking, running or hopping. Pain is usually felt with initial activity, then eases as the tendon warms up and increases again when you stop the activity. It is common to have morning pain and stiffness, local tenderness over the tendon and sometimes visible redness or swelling.
Management of Achilles tendinopathy requires accurate diagnosis by your physiotherapist. Research shows that the most important and effective treatment for this injury is to progressively load the tendon. This is achieved with isometric and isotonic exercises, as well as progression of the high and fast load and sport specific training. As the injury is related to overuse, the exercise and progression back to sport needs to be guided by your therapist and individually tailored to your injury and your personal goals.
Your physiotherapist might also use manual therapy, icing, taping, a heel wedge or orthotics and guidance of self-management strategies.
Recovery time can be quite long, as tendons heal slowly and progression of the loading program takes time. You could be off sport for weeks or months, so be patient and avoid disappointment.
Treatments to Avoid
Treatments that research has shown to be less effective and are not recommended include cortisone and blood or PRP injections. However these injections and surgery are still very occasionally performed. They should only be used as a last resort under direction of a medical specialist.
The Best Advice
- Reduce the risk of injury. Whatever your age, sudden increases in exercise, particularly the intensity of exercise is a key cause of tendon injuries
- If you have pain with exercise, stop the activity that caused it. Come in to see us if your pain doesn’t settle in a couple of days. It could save you months of pain and lost time in your favourite sport.
Remember: Consult with us first if you have any health conditions or concerns about exercise. We can help you safely take up a new physical hobby so you can enjoy it well into the future.
Call us on (02) 6251 3487
Written by Jacinta Searles
Exercise alone provides psychological and physical benefits. However, if you also adopt a strategy that engages your mind while you exercise, you can get a whole host of psychological benefits fairly quickly.
~ James Rippe, MD