Your Guide to Achilles Tendinopathy
This information has been prepared to help you fully understand your condition so you will be in the best position possible to work with your physio & follow the steps to your full recovery. Understanding the goals of your treatment & having complete confidence in your physio are vital elements of your recovery plan, so if you have any questions then please feel free to ask your physio.
Achilles tendinopathy is a term used for conditions which affect the Achilles tendon (the band of fibres that connect the calf muscle to the heel bone). Problems are usually caused by overuse or repeated movements during sports, work or other activities. Other factors include poor footwear & changes in training frequency & intensity.
A tendon connects muscle to bone. The Achilles tendon connects 3 muscles (the gastrocnemius, soleus & plantaris muscles) into the heel bone. It is the thickest & strongest tendon in the body. This tendon allows you to rise up on your toes & push off when you walk or run. When the tendon becomes overloaded (eg. running up a hill), inflammatory changes within the tendon can occur causing thickening of the tendon. Over time, with repeated overload, the tendon may not heal adequately & microtears can form in the tissue in & around the tendon.
Symptoms of Achilles tendinopathy include mild to severe pain at the back of your heel over the tendon. Pain can come on gradually & may only occur as you begin or end a walk or run. There may also be swelling in the tendon or ankle area.
What Happens If I Don`t Fully Fix My Back?
If an activity is causing repeated stress to the Achilles tendon & causing you pain it is important to seek advice early. If left untreated your pain may become constant & will require a longer period of rest from your activity.
In more severe cases normal everyday walking everyday walking can become difficult & the Achilles may not heal with physiotherapy.
The tendon will also become vulnerable to rupturing due to the chronic degeneration. If this happens then surgery & extensive rehabilitation is usually required to repair the rupture.
How Long Does It Take To Get Fully Better?
This will depend on the severity of your injury. If you seek advice early to control the problem then you could make a full recovery in 8-10 weeks. However, the rate of recovery differs from patient to patient, & in some cases can take up to 6 months. You will normally be gradually returning to running during this time.
Your journey to peak performance with Central Physio
Your physio has been extensively trained to thoroughly assess & diagnose your injury. They will give you a step-by-step recovery plan to make your treatment easier for you to understand. The most common phases, or steps, that you will go through during your recovery plan are outlined below. The order & timing of the phases are tailored individually for you & so may vary from this list. Please feel free to ask your physio if you have any questions about your recovery plan.
Phase 1: Symptom Control
The first goal of treatment is to settle your pain down. Treatments we commonly use to achieve this include massage to release tight muscles, heel lifts & activity modification to reduce tendon loading, ankle mobilisations if joint stiffness is a problem, & early isometric calf exercises. Ice may also be used in the clinic & at home. During this phase you will need to avoid any activities that aggravate your pain & stop your tendon from healing, & your physio will discuss this with you.
Phase 2: Restore Muscle Length
When your muscles are tight they put stress on tendons (the ends of muscles) at the point where tendons attach to the bones. Tight muscles can make the job of other muscles harder & cause too much load on joints, & they also change the way you move & can stress other parts of your body. Therefore it is important to get your full muscle length back to stop this from happening.
Your physio may use techniques including stretches, muscle & soft-tissue releases, & specific exercises to help regain your flexibility. They may also show you how to use a foam roller or trigger-point release ball at home to allow you to work hard on restoring your muscle length as fast as possible.
Phase 3: Improve Muscle Strength
Weak muscles are a major problem when recovering from an injury. Often muscles are weak because they are not being used properly, they have been damaged, or they have been weakened after an injury.
When strengthening muscles you must strengthen the correct muscle & in the way the muscle would normally be used. To improve your muscle strength your physio may show you exercises using bodyweight, free weights or theraband.
Phase 4: Correct Biomechanics
Your biomechanics (how you move) play a big role in causing, repairing & preventing Achilles injuries. They can also help in improving performance. When you have poor foot biomechanics your body is not working as well as it could & this puts strain on other areas of your body including your knees, hips & even your back. Correcting your biomechanics will ensure your body can work at its best.
Techniques used to correct biomechanics are Gaitscan Custom Orthotics, taping techniques, specific strengthening & examining training techniques. Shoe assessment is also important.
Phase 5: Sports/Ballistics & Advanced Strengthening
This is the last phase of your journey to full recovery. When you are returning to your activity you must be able to do it at full speed & resistance before being back in the game. You need to be able to apply your speed & force with the correct technique in training first to prevent another injury. In this phase we tailor exercises specifically to your activity by doing advanced sports-specific strengthening & high speed movements combined with rapidly changing directions. This phase is essential both for getting your back to your full level of performance, & also for preventing re-injury due to persisting background weakness or reduced co-ordination of muscle contractions.
Many clients find that seeing one of our Exercise Physiologists, Strength & Conditioning coaches or Personal Trainers is a great way to build strength, ability & confidence for a smooth return to full sporting activity. If Pilates is more your style then our great Sports Pilates program is an ideal way for you to continue to build your stability & strength. As well as being an important part of your rehab program these services can help you lift your sports performance whilst staying safer & reducing your risk of future injury.
For more information or to speak with one of our physio’s to discuss your symptoms please call us on 9280 2322 or contact the clinic.