Achillies tendinopathies are degenerative conditions caused through overuse. This overuse causes micro damage to the tendons and if the tendons aren’t given time to recover between sessions the micro damage accumulates. As the damage accumulates your symptoms will start to appear, by the time you start to feel pain, significant damage has already occurred. Because there is a poor blood supply to the tendons recovery can be a lengthy process. Many cases without appropriate physiotherapy treatments have been known to drag on for many years.
Achillies tendinopathies are very common amongst athletes especially those involved in sports such as athletics, volley ball, football and racquet sports. Every step you take whether walking, running, dancing or jumping places significant forces through the achillies tendon. This injury is not just confined to athletes and can effect a wide variety of people, especially as they age.
Generally achillies tendionpathies start as an ache or stiffness in the achillies first thing in the morning or on the commencement of exercise. You may find that stretching or a heat rub may give you some intermittent relief, however if the cause of your injury is not found the injury will generally progress. Once this condition becomes chronic you will find great difficulty walking when you first get out of bed or when you start to jog. As there will be significant damage to the tendon itself you will be susceptible to tears or achillies ruptures. This is why it is a lot easier to treat a tendinopathy in its early stages rather than wait until it becomes so chronic you have to do something about it.
The biomechanics of the foot are very important. If your foot over pronates the biomechanics of your foot will be altered changing the direction of force on your achillies tendon. As the achillies tendon is designed to resist the force from one specific direction a slight change in this direction will cause it significantly more damage. This explains why a sudden change in footwear is often associated with achillies tendinopathies.
Causes of achilies tendinopathies:
An increase in running mileage.
Increased amounts of time spent on your feet.
Poor selection or progression of exercises.
Please refer to tendinopathies for an in depth description of tendinopathies.
Signs and symptoms:
- Pain in your achillies.
- Tender on palpation.
- Stiffness first thing in the morning or on initial activity.
- Pain and stiffness decrease after a good warm up or a hot shower.
- Pain eases with extended periods of rest.
- Swelling or thickening of the tendon.
Physiotherapy treatments for achillies tendinopathies include:
- Soft tissue mobilisations (specific massage techniques).
- Mobilisations to restore full joint movements.
- Specific strengthening exercises to effect remodelling of the tendon.
- Correcting abnormal biomechanics especially of the ankle, knee or hips.
- Improving standing, walking and running techniques.
- Improved movement biomechanics.
- Strengthening of the foot to correct poor biomechanics ie collapsed arch.
- Prescribing orthotics.
- Putting wedges into shoes if required.