Achilles Tendinopathy (AT) is a condition that causes pain, swelling and stiffness, as well as weakness of the Achilles tendon, writes Laura Harington, Chartered Physiotherapist at the arena clinic.
With a lot of you switching to road running and home video exercise regimes that involve a lot of jumping/skipping activities due to the current climate, you may find yourself in a position of having Achilles tendon pain.
It is the largest tendon in the body, enabling you to walk, run, jump and go up and down stairs, sometimes tolerating up to 10 times one’s body weight in running/ jumping activities.
Over-use or repeated over-load such as road running or repeated hopping, skipping and/or jumping activities may cause AT. After an injury, the tendon does not heal completely as it should. Instead, cellular changes occur to the tendon and its surrounding tissue. This does not make the tendon weak, but it does make it challenging for it to tolerate loads during running and walking.
AT is quite common, affecting 6% of in-active people. Research suggests men are more susceptible t while individuals in their 30s and 40s have been shown to have a greater incidence.
Causes… not all!
- Over use: runners,
- Change in training load: increase in training intensity/ type/ duration
- Inappropriate Footwear: poorly fitted, worn or flat; i.e. converse runners or flip-flops
- Training on hard/ sloped surfaces: road, astro –turf, etc.
- Poor flexibility (primarily in the calf and hamstring muscles)
- Poor lumbo-pelvic control- i.e. hip/ pelvic/ core strength
Signs and Symptoms
- Pain/ stiffness at the back of heel/ lower leg.
- Tenderness upon touching of the tendon.
- Swelling at the back of the heel.
- Interference with day to day life — walking to the shops, up/ down the stairs
- Pain will typically ‘warm up’ during the first 5-10 minutes of a run. This often stops people seeking help as they can run through the pain. As time progresses, pain will be felt when one stops training and from there, during training, often causing a complete cessation of training/running due to the severity of symptoms.
First Line treatment for Achilles Tendon Pain typically consists of;
Rest from the aggravating activity and allowing the symptoms to reduce/ subside: if an activity as simple as walking does not cause pain during, immediately after or in the days following the activity,you can continue to do same.
Adequate footwear: ensure you do not wear any flat footwear and reside in a pair of well-structured shoes: i.e. runners
Stretching: Calf muscles
Strengthening: Eccentric heel raises: may start with concentric holds and progress to eccentric heel raises as able (start with double and progress to single leg)… aim for 3 x 15
Foam rolling: calf musculature
Gluteal/ hip stability: strengthening exercises: clam shells, hip abduction, fire hydrant, hip extension
Google the above exercises for further input if unsure how to correctly perform them. All the above should be relatively pain-free throughout.
As symptoms start to reduce, you can start a gradual return to exercise, but ‘phased’ being the optimum word. If symptoms reoccur, return to a stage previous. It may take days up to a few weeks to resume normal activity, pending the severity and length of time symptoms existed.
If symptoms persist, do not hesitate to contact the team here at the arena clinic for assistance.