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Managing Achilles Tendinopathy

What is it?

The Achilles Tendon is the longest tendon in the body that connects the heel bone to the calf muscle. Its role is to absorb high energy loads from the ankle into the calf. It’s like a spring, storing energy and then releasing it while we walk and run.

Achilles tendinopathy describes changes in the tendon structure that cause it to not cope with normal loads as well as it used to.

What is it caused by?

Tendinopathy can be contributed to by many risk factors. The main risk factors are a sudden increase in activity, particularly walking, running or jumping and loads that compress the tendon. Lower limb biomechanics issues may also predispose someone to Achilles tendinopathy, and with these people, even small changes in activity may lead to tendinopathy occurring.

Achilles tendinopathy tends to occur in either the athletic population or middle to older aged people.

Symptoms of Achilles Tendinopathy

· Pain in the Achilles tendon focused in a small area

· Stiff feeling first thing in the morning or after sitting down for a long time

· Thickened and swollen tendon

· Feels a bit better when ‘warmed up’ but worse towards the end of or after physical activity

What can we do about it?

One thing we do know about tendinopathy is that it DOES NOT improve with rest – the pain may settle but returning to activity is often painful again because the rest time does nothing to increase the tolerance of the tendon to being loaded.

Exercise is the most evidence based

treatment for tendinopathy – tendons need to be loaded progressively so that they will develop increased tolerance to loads that you need to endure in your day to day activities. In a majority of cases, tendinopathy will not improve without this vital load stimulus

Early on with tendinopathy it is important to modify load – reducing tendon overload that involves energy storage and compression.

Even though exercise is the most evidence based treatment, tendinopathy responds very slowly to exercise – you definitely have to have patience and not expect a quick recovery.

Physiotherapy management may also include massage, taping and possibly orthotic treatment if foot mechanics are a contributor to the problem.

Our physios will guide you through the rehabilitation process, help you manage your activity, and prescribing exercises to progressively load the tendon to ensure that it improves over time.

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