Achilles Tendinopathy
What is Achilles Tendinopathy?
Achilles tendinopathy is a condition that occurs when the Achilles tendon is aggravated and injured. The Achilles tendon is a strong, fibrous band of connective tissue that connects the calf muscles to the heel bone. It is the largest and strongest tendon in the human body.
Achilles tendinitis refers to micro-tears in the Achilles tendon due to repetitive overload followed by inflammation.
Achilles tendinosis refers to degeneration of the Achilles tendon’s collagen due to excessive and prolonged overuse after the onset of tendinitis without giving the body enough time to heal. The full inflammatory process is an important for tendon healing and is absent in tendinosis.
More information about tendinopathy, tendinitis, and tendinosis.
It is important to note that early diagnosis and prompt treatment can help prevent further damage to the Achilles tendon and improve outcomes. If left untreated, more invasive treatments such as injections or surgery may be necessary.
What Contributes to Achilles Tendinopathy
1. Overuse
Achilles tendinopathy is a common overuse injury among athletes who participate in sports that involve jumping, running, or sudden changes in direction, as well as in individuals who engage in repetitive activities such as working long hours while standing and walking.
2. Calf Overuse
People who stand, walk, and run with calf dominant muscle recruitment are more likely to develop Achilles tendinopathy.
3. Muscle Imbalances
Decreased strength and stability in the hip and knee musculature can cause the calfs to compensate, increasing the load on the Achilles tendon.
4. Age
Achilles tendinopathy is more common in people over the age of 30, as the tendon can become less flexible and more prone to injury with age.
5. Obesity
Being overweight can place extra stress on the feet, which can increase the risk of developing achilles tendinopathy.
6. Underlying Inflammatory Conditions
People with inflammatory conditions including diabetes and rheumatoid arthritis are at a higher risk of developing achilles tendinopathy.
How does physiotherapy Treat Achilles Tendinopathy?
Resolves the root cause
During the assessment, your therapist will explore which factors are contributing to your achilles tendinopathy. Your therapist will then provide treatments to correct your walking mechanics, prescribe exercises, and educate you on how to manage and reverse your achilles tendinopathy.
management Strategies
1. Manual Therapy
Myofascial release: to reduce pain, tightness, and inflammation of the joints, nerves, and fascia in the lower leg, foot, and surrounding tissues.
Joint mobilization: to promote smooth joint movement and mobility of the hips, knees, foot, ankle, and other affected areas.
2. Biomechanical Optimization
Movement pattern and gait conditioning: relearning how to walk with proper lower leg and foot mechanics will limit inflammation of the Achilles tendon.
3. Exercise Therapy
Stretching: to improve flexibility and reduce the tension of the lower leg muscles and Achilles tendon.
Strengthening: to improve the activation and stability of the muscles in the upper leg, lower leg, and foot muscles, which can benefit overall function and reduce the risk of further injury.
Home exercise program: individualized exercise prescription to restore optimal and balanced movement.
4. Modalities
Shockwave therapy: use of high-energy sound waves to improve blood flow, break down scar tissue, regrow new tissue, reduce pain, and stimulate healing processes.
Taping: to support the Achilles tendon and calf muscles.
Acupuncture: use of thin needles to improve local and systemic function, regulate the nervous system, and promote the body’s natural healing processes.
Heat and cold therapy: to manage reduce pain and tension or control inflammation.
Electrostimulation: use of electrical currents to stimulate muscles and reduce pain.
Ultrasound: use of high-frequency sound waves to produce deep tissue heating to reduce muscle tension, fascial tension, and inflammation.
Laser therapy: to improve blood flow, reduce pain and inflammation, and promote tissue healing.
5. Education
Recommendations regarding activity modification, posture, and shoe wear to help reduce load, risk of recurrence, and further injury.