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Achilles Tendinopathy: A common injury with a simple approach.

Achilles Tendinopathy: A common injury with a simple approach.

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Running and walking are efficient ways to get and stay fit. We see the streets crammed with people pounding the pavement to keep their step’s up. It makes a lot of sense, the more steps you take, the fitter you are.

However, we need to consider what happens when you increase your intensity or volume of exercise too quickly when chasing your fitness goal. One of the most common injuries we have seen recently  in the clinic is Achilles Tendinopathy.

The Achilles tendon is the largest tendon in the body, it is responsible for absorbing the stress of landing, and providing the power to push you off the ground when walking and running. So as far as function goes, it is super important.

Anatomically the tendon connects into the heel bone, and then into the calf muscle, so as described above, it works as a spring to drive the foot off the ground, it supports the whole body so it needs to be strong and durable. So you can imagine when injured or sore, it impacts not only your exercise, but also your day to day life. So what is Achilles Tendinopathy?

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What is Achilles Tendinopathy?

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When the Achilles is sore there is usually a reason. When presenting to the clinic with pain, our clients usually describe an increase in sport or any activity, which intern equates to an increase in stress on the tendon. Stress or load is what we need to strengthen any structure, however when placed upon the tendon when the tendon can’t cope with it, we see an overload of tissue.

When the Achilles is sore there is usually a reason. When presenting to the clinic with pain, our clients usually describe an increase in sport or any activity, which intern equates to an increase in stress on the tendon. Stress or load is what we need to strengthen any structure, however when placed upon the tendon when the tendon can’t cope with it, we see an overload of tissue.

This is the same with running, if we are overloading our Achilles tendon when it can’t cope, we end up with pain and injury.

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How is my injury diagnosed?

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This diagnosis is relatively simply, of course there is some situations where it becomes more complicated, however we find this diagnosis the easiest part of the injury.

To best diagnose your injury as Achilles Tendinopathy we should consider the anatomy, looking at the graphic below we can see the injury can be either at the middle of the tendon or where the tendon inserts into the heel.

When the Achilles is sore there is usually a reason. When presenting to the clinic with pain, our clients usually describe an increase in sport or any activity, which intern equates to an increase in stress on the tendon. Stress or load is what we need to strengthen any structure, however when placed upon the tendon when the tendon can’t cope with it, we see an overload of tissue.

We preface this diagnosis by saying not all cases are the same.

Once the accurate diagnosis is made we need to ensure we treat this injury efficiently and with minimal interruption to training. Our aim is to always to keep the person active, active without jeopardising the ultimate goal of resolving the injury.

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How do I treat Achilles Tendinopathy?

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.Short Term Achilles Tendinopathy.

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This is generally diagnosed if you have had the injury for less than two to three weeks, it is really important that if you fit this category you can follow these steps to increase chances of a swift recovery.

Isometrics calf loading is a an effective exercise in reducing pain and improving function, shown below.

Load ModificationSignificant reduction in exercise 50-70%
Isometric Calf LoadingPain relief and tissue capacity
FootwearBest fit for comfort
Heel RaisesOffloading

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Longer term Achilles Tendinopathy

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More chronic cases, or cases that have been around for longer than four weeks are a little more progressed and it is really important your injury is managed by a Podiatrist.

Here we see changes to the tendon under ultrasonic scan, thickening of collagen fibres (tendon structure), swelling in the tendon and areas of degeneration.

Below we have listed some of the more common ways we can recondition the tendon.

Load modificationReduction of exercise but not rest
Isometrics Calf LoadingDaily: pain relief and strength
Heel lifts4-10mm in height
FootwearComfort and biomechanics
Strength workCalf raises: bent knee and straight knee
Biomechanical assessmentPodiatrist
Orthotic therapyIf appropriate

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Can Achilles Tendinopathy be cured?

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There are numerous treatment modalities for Achilles Tendinopathy. When prescribed correctly these lead to a very successfully resumption to full exercise with no pain.

The table above fails to cover every option we have, but it gives a great account of simple things to do at home. We continue to understand more about this injury the more it is studied, one thing we know for certain is it can be really stubborn, and having a podiatrist assess and prescribe the appropriate interventions will ensure you are back exercising with no pain.

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If you are interested in reviewing your injury you can click this link book an appointment and get it started today.

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https://www.instagram.com/sespodiatry/

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Achilles Tendinopathy