What is an Achilles Tendinopathy?
— A degenerative condition in which loads exceed the tendons capacity over time. In most cases it occurs when an individual increases their load.
Why am I writing about this?
— As a sprinter I experienced an Achilles tendinopathy mid-season this year due to a training overload which was then successfully rehabbed through Physiotherapy treatment in 12 weeks.
An Achilles Tendinopathy can occur during…
— Sports where training loads are increased (more running, sprinting, change of direction)
— You may have started running again after not running in years
— You may have spent more time in the garden than you usually do
— A sudden increase in walking volume, especially up and down hills
What are the key signs of an Achilles Tendinopathy?
— Pain on palpation 2-6 cm above the heel bone and on the tendon
— Morning stiffness
— Pain improves when warmed up but is worst post exercise or aggravating activity
— Thickening of the tendon (only sometimes)
— Gradual onset
Peritendinopathy (surrounding sheath)
— Widespread pain throughout the Achilles area, less pinpoint
— Pain is more sudden after load increase
Why is it important to see a physio and differentiate these?
— Achilles tendinopathy responds well to a load-based rehab where appropriate loading exercises prescribed from your physiotherapist will help the tendon remodel with collagen and be able to tolerate load bearing to resume high load bearing activities. It will also provide an immediate pain reduction by reducing pain signalling in the acute stage.
— Peritendon pain requires more rest in the acute stage and friction of the area needs to be reduced. This can be done with footwear modifications, load reduction, taping and non-load bearing physiotherapy prescribed exercises until the pain has settled.
Should I see a Physiotherapist for this condition?
— Yes! A gradual loading program prescribed by a Physiotherapist may allow you to return to full activities whether that is walking, gardening, sports or anything else pain free. Physiotherapy will initially give you the tools to reduce your pain and can provide hands on treatment to fast track the process.
How long will it take to get better?
— 3-6 months with rehab but without treatment and in severe cases this can extend to 9-12 months plus.
Key Takeaway:
— If you experience heel pain, see your local Physiotherapist as soon as possible as early rehab is associated with much improved results compared to delayed rehab.
By Mitchell Mullens
Physiotherapist
ASCA Level 1 Strength & Conditioning Coach