The Achilles tendon is a thick, fibrous tissue that attaches your calf muscle to your heel. It is responsible for movements like pointing your toes, running and jumping. Achilles Tendinopathy is a common condition producing pain and stiffness around the heel, back of the ankle and the back of the lower leg. It is an over-use injury which can occur when there is increased demand on the Achilles tendon beyond its usual capabilities.
It can be triggered by an increase in activity, for example, taking up a new sport or increasing your exercise regime. It can even come on with change in footwear, for example going from your work shoes to unsupportive thongs over Summer.
It is common for the pain to be there upon waking and walking or getting out of the car after a long drive. The pain tends to increase when the tendon is loaded, after a period of immobility.
How is it diagnosed?
Diagnosis of Achilles Tendinopathy can be made by a Physiotherapist or other Health Professional via a comprehensive History taking and Physical Examination. Diagnostic Ultrasound may be performed but is rarely required. A Physiotherapist also performs a range of physical tests on the foot and ankle to exclude other conditions.
How is Achilles Tendinopathy managed?
Achilles Tendinopathy is managed in 4 phases: Acute, Recovery, Rebuilding and Return to activity. These phases can be managed in partnership with your Physiotherapist who have particular skills in loading the tendon safely. It can be a lengthy period of rehabilitation, which may take around 12 months to get you back to pain-free activity so it’s best to get started with your Physio as soon as possible.
Interestingly, there is no relationship between having Achilles Tendinopathy and rupturing your Achilles tendon. You have no increased risk to rupturing your Achilles tendon if you have Achilles Tendinopathy.
Physiotherapy Treatment for Achilles Tendinopathy:
Treatment may include:
- activity modification & footwear advice or modification (to reduce load on the tendon and reduce inflammation)
- Circulation exercises (to improve blood flow to the area & stimulate healing).
- Stretches (need to be supervised by your Physio as they don’t help for every case).
- Strength training (must be gradual to gradually increase the load through the tendon safely without flaring it up).
- Therapeutic Ultrasound / massage +/- anti-inflammatory gel / ice / heat / superficial dry needling are all treatment modalities commonly advised and used by Physios for this condition.
- Referral on to a Podiatrist who does Electroshock Wave Therapy (ESWT) may be considered in the long term if symptoms do not resolve.
As always, our Physiotherapists can help you with optimal evidence-based treatment to aid your recovery from Achilles Tendinopathy. If you are suffering with this condition, or know someone who is, please give us a call on 9859 5585 or book an appointment.