Achilles tendinopathy, a condition often affecting athletes and active individuals, involves the overloading of the Achilles tendon, which connects the calf muscles to the heel bone. At the Corio Bay Sports Treatment Clinic, we believe that understanding the causes, symptoms, and treatment options for Achilles tendinopathy is crucial for effective management and recovery. This blog aims to provide an in-depth overview of this condition, offering insights and practical advice to help you stay informed and proactive in your treatment journey.

Achilles tendinopathy encompasses a range of tendon injuries, primarily characterized by pain, swelling, and impaired function. It is broadly classified into two types:

1. Insertional Achilles Tendinopathy: Occurs at the
point where the tendon attaches to the heel bone.

2. Mid-portion Achilles Tendinopathy: Affects the
middle section of the tendon, typically 2-6 cm above
the heel insertion.

     Several factors can contribute to the development of Achilles tendinopathy, including:

    – Overuse: Repetitive stress from activities such as running or jumping overload the tendon.

    – Improper Footwear: Wearing shoes without adequate support can strain the Achilles tendon.

    – Sudden Increase in Activity: Rapidly increasing the intensity or duration of physical activity can predispose individuals          to tendon injuries.

    – Biomechanical Issues: Poor foot mechanics, such as flat feet or high arches, can place additional stress on the tendon.

   – Age: Tendon elasticity decreases with age, making older individuals more susceptible to tendinopathy.

Common symptoms of Achilles tendinopathy include:

• Pain and Stiffness: Especially noticeable in the morning or after periods of inactivity.
• Swelling: Around the tendon, which may be accompanied by warmth and tenderness.
• Limited Range of Motion: Difficulty flexing the foot or walking, particularly after exercise.
• Thickening of the Tendon: A palpable thickening of the tendon may be felt in chronic cases.

A thorough clinical examination is essential for diagnosing Achilles tendinopathy. Your Physio will:

• Assess Medical History: Discuss your symptoms, activity levels, and any previous injuries.
• Physical Examination: Evaluate the tendon for signs of pain, swelling, and range of motion.
• Imaging: Ultrasound or MRI may be used to confirm the diagnosis and assess the extent of tendon damage.

Effective management of Achilles tendinopathy typically involves a combination of the following approaches:

STRENGTHENING IS THE KEY to managing this condition. 

Specific exercises will be prescribed to strengthen the calf muscles and improve endurance and resilience in your tendon. 

For Athletes, over time you will be progressed to Plyometrics and Jumping Specific exercises will be taught.  If your goal is just to walk or jog pain free, then your program will differ in intensity to a high level athlete. 

Picture of someone doing a single leg calf raise with line drawn on foot and Rei instructing.

Activity Modification: Reducing or modifying activities that exacerbate the condition to allow the tendon to heal are important.  

When acute and painful the initial management is to reduce the training loads significantly but rarely are we asking athletes or clients to have complete rest.  Complete rest for tendons is actually counterproductive rather than helpful.

Activity levels also depend on whether an athlete is in competition mode or their off season.  If still competing, then these games or training sessions would be considered higher tendon load sessions and trying to do plyometrics on top of this would be too much.  However, in a non-competition phase once baseline strength has been built up the higher load sessions would be programmed into the weekly program on one to 2 days a week.

Pain Management: Over-the-counter pain medication and ice may be used to alleviate symptoms in the early downloading phase.

Orthotics: If your Foot Posture is considered a risk factor Custom shoe inserts can help support the foot and reduce tendon strain. We will determine if this is necessary and refer to our Podiatry team if required.

Shock Wave Therapy: This modality can be provided by our podiatrists at Profeet for persistent Achilles tendinopathy problems.

Preventing recurrences of Achilles tendinopathy involves adopting a proactive approach to tendon health and loading:

• Gradual Increase in Activity: Avoid sudden increases in the intensity or duration of exercise.
• Proper Footwear: Wear shoes that provide adequate support and cushioning.
• Foam Rolling or Massage can help with managing muscle soreness and keeping your calves supple which can reduce tendon load
• A maintenance Strength Training program is advisable and will be tailored to you by your physiotherapist
• Listen to Your Body: Pay attention to any signs of pain or discomfort and address them by managing your load appropriately.
• Foam rolling: can be a great technique to help loosen tight muscles as stretching is often not indicated.

Achilles tendinopathy can be a debilitating condition, but with the right knowledge and approach, effective management and recovery are possible. At Corio Bay Sports Treatment Clinic, we are committed to providing you with the latest insights and practical advice to help you navigate your journey towards recovery. Remember, early intervention and consistent care are key to overcoming Achilles tendinopathy and returning to your active lifestyle.

For more information and personalized guidance book an appointment today.

Stay informed, stay active, and take charge of your tendon health!