How do I treat My Achilles Injury?

How do I treat my Achilles pain?

Grant Brauer – Physiotherapist

In his blog Colac Physiotherapist Grant Brauer will explain the causes and treatment options for people suffering from Achilles Tendon conditions or injuries.

Achilles tendon pain is a very common injury affecting athletes and weekend warrior’s alike. It is especially prevalent in runners and people who play sports that require running (team sports, football, netball) and also sports that produce high impact loads through the leg (volleyball, fast bowling in cricket). It can also affect anyone who spends a great deal of time on their feet at work.

What is The Achilles Tendon?

The Achilles tendon is the long, thick piece of connective tissue at the back of the ankle and lower leg connecting the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). It is an incredibly strong, resilient structure and it needs to be. Think about how many steps walking, running, jumping, hopping, dancing (badly in my case) you have taken during your lifetime. The Achilles Tendon is required to withstand the load of the entire body (sometimes more than the load of the body) on each of those occasions.

The Achilles tendon is designed to store energy as the foot and ankle is pointing up (like when the foot is just about to push off when running). This is called dorsiflexion. This stored energy is then released it to help propel when the foot and ankle points down (like when you push off to jump into the air). This is called plantarflexion. The Achilles tendon is also well designed to help absorb load when landing from jumping.

If my Achilles tendon is so strong, how did it get so sore?

While the achilles tendon is very strong by nature, it is susceptible to becoming overloaded just like any other tissue in the body. All tissues in the body respond to the load that is placed upon them. Some tissues respond and adapt to load relatively quickly, whereas other tissues can respond relatively slowly. As we get older all of the tissues in the body respond and adapt slower than they used to and this can be the case for the Achilles tendon in particular.

Does this mean that I should avoid my favourite exercises if I have Achilles pain?    

No – one of the least helpful things you can do if you develop Achilles pain is to stop activity completely. While it might feel uncomfortable to continue with exercise and activity one of the best things to do is to remain active. Remember all tissues in the body respond and adapt to load, so if you stop exercise and activity all together the Achilles tendon becomes weaker. This means that it’s ability to store, release and absorb load diminishes.

Sure, while you are resting the pain might subside, but if you rest completely for too long you will find that when you do eventually resume activity the will likely return. It’s not just the Achilles tendon that will have become deconditioned during your resting phase. Generally you will be less fit, less strong and you might have even put on a cheeky kilo or two. This will only compound the problem and make it more difficult to get going if and when your pain settles.

So, what should I do about my Achilles pain?

Research into tendon rehabilitation has shown that the main focus ought to be on load management. One of the most difficult things for someone dealing with Achilles pain is trying to work out how much is activity is ok. This is where speaking to a Physiotherapist can be very helpful. We can help you to establish a baseline of activity that allows the tendon to be exposed to an appropriate amount of load, without overdoing it and causing you more pain.

There are many aspects of load that need to be considered. The magnitude (ie, how heavy), the frequency (ie how often), the duration (how long) and the type (ie high impact, low impact). A Physiotherapist can help discuss these aspects of load in the context of your goals and lifestyle factors.

Does that mean I should ignore my Achilles pain and just push through it?

No, not exactly. Pain is not something to fear, but is also not something you should ignore. It is your body’s way of telling you that the load is too great for the tendon. Pain should be respected. Discussing the relationship between pain and load on the tendon can be a very effective way of helping you understand what is an appropriate amount of load for your tendon. This is an important part of establishing a baseline of activity.

Is there anything else I should know?

Yes. If you already have Achilles pain then please don’t expect a speedy recovery. While it is nice to know that human tissue has the ability to respond and adapt to load it is important to remember that the Achilles tendon takes much longer to adapt than many other musculoskeletal tissues – so be patient with yourself and the process and stick to the plan that you and your Physiotherapist agree upon.

So, what now?

If you have Achilles pain and would like to learn more about how we can help you give us a call on (03) 5232 2400 or make a booking online at www.cbstc.com.au.