Tame Your Achilles Tendon Pain!
With the warmer weather and a new year in sight it is likely many of you are experiencing a surge in motivation to get your body moving more – however it is important to bear in mind that doing too much too soon or too quickly can wreak havoc on the body if unprepared! In this article we will touch specifically on Achilles tendinopathies unravelling the who, what’s, how’s and why’s behind why your Achilles might be angry.
What is a tendon?
A tendon is a well-organised collagenous tissue designed to bear large loads and act as an imperfect spring as we move our body. Tendons are all over the body connecting our muscles to our bones and work to store and release energy to produce high and fast loads that allow us to walk, run and jump at max efforts!
Who gets Achilles tendinopathy?
Achilles tendinopathies hold no prisoners affecting nearly all population groups – young & old, walkers & runners and those playing multi directional sports. So what causes tendinopathies to develop? The largest risk factor for developing a tendinopathy is a sudden and unprepared change in load – for the Achilles this could include:
• Increased distance of walking/running
• Increased speed
• Introducing hills
• Change of footwear
• Change of surface
• Training for an event
This change in load causes the tendon to become overloaded resulting in a cascade of changes within the cell make up of the tendon resulting in inflammation and often pain.
Symptoms of Achilles tendinopathy:
Those with Achilles tendinopathy will often complain of localised pain over the Achilles insertion, pain that is worse with walking or hills, morning pain/stiffness. Typically pain associated with a tendinopathy will be worse before and after a session and tend to improve throughout the session itself.
How to manage Achilles tendinopathy?
So what to do if this is all sounding a little too familiar? It is a common misconception that when experiencing pain we should immediately stop all aggravating activities and rest – however when dealing with tendons this is not the case. Due to the nature of tendinopathies it is important that part of the treatment involves loading the tendon to improve its capacity to store and release energy through explosive movements.
Initially to reduce pain you may be required to partially de-load your tendon and stop explosive efforts that require large amounts of stretch & shorten through your muscles. This could include reducing the km’s you walk/run by 50% and resting from all jumping activities while working on slowly loading the Achilles tendon.
In the initial stages of your Achilles tendinopathy your health professional may use therapies such as:
• Manual therapy – soft tissue massage, joint mobility and stretching
• Myofascial dry needling
• Taping to offload the affected area
• Heel wedges or orthotics
Those with Achilles tendinopathy may also find it useful to:
• Limit prolonged standing
• Limit calf stretching
• Limit flat shoes/barefoot
Finally your health professional will work with you to develop a rehab program that will target strength of the Achilles tendon – this will likely include isometric exercises, which require you to hold a certain position for periods, isotonic exercises such as calf raises and in the later stage the introduction of specific hopping, jumping and explosive exercises to ensure a safe and pain free return to walking, running or sport!
For more specific and tailored advice be sure to chat to your Osteopath to work out a plan that works best for you and to address any barriers or fears you may have associated with your Achilles pain. Always consult your healthcare provider before commencing a new exercise program.