Achilles tendinopathy is an awfully common complaint that we see in a range of our mostly healthy and active patients. This sort of Achilles or calf pain is usually thought to be due to tiny micro-tears in the tendon which can develop over time. These tears can occur with a single incident of overstretching or straining or through general use when the tendon becomes worn and damaged with repeated loading.
Many factors can contribute to the development of Achilles Tendonitis or tendinopathy;
- Wearing high-heeled shoes that shorten the calf muscle
- A rapid increase in training or walking frequency or load
- A reintroduction of running and pivoting type sports
- Poor footwear that either rub against the tendon or fail to support the foot adequately
- Training on hard or uneven surfaces – beach and up hill running are notorious for this
- Insufficient stretching or recovery between training sessions
- Poor foot biomechanics and strength – excessive pronation is the most common
- Weight gain
Symptoms of Achilles tendinopathy typically include pain in the Achilles tendon, heel or lower calf. Tenderness to pressure and some redness and swelling are common. The pain will often come on with activity and may completely disappear with rest…only to come back again! There may be difficulty rising up onto your tippy toes, especially when standing on 1 leg only.
Early assessment and treatment for this sort of problem is vital as it has a tendency to degenerate fairly rapidly and can become really difficult to resolve the longer it’s been there. Full rehabilitation is important to achieve an optimum outcome and limit the chance of reoccurrence.
Treatment may include:
- Rest from provocative activities
- Ice or heat
- A targeted stretching and strengthening program to loosen muscle and joint structures that may be impairing the normal function of the calf and ankle joint
- A broader rehabilitation program that addresses any weakness in the small muscles of the foot and hips that frequently lead to Achilles overload
- Regular massage and soft tissue therapy
- Bracing or taping may be used to offload the muscle and tendon
- Correction of foot biomechanics if needed – advice on footwear and/or orthotic prescription
- A functional strengthening program to prevent re-injury