Achilles tendinopathy

Achilles Tendinopathy

What is an achilles tendinopathy?

The word tendinopathy refers to degeneration, partial tears of the tendon and/or irritation to the peritendinious junction (the surrounding of the tendon). Much like A hamstring tendinopathy, achilles tendinopathies occur at the sit of the achilles (lower leg). Whilst hamstring and achilles tendinopathies very different conditions, the risk factors, prevention and rehab are very similar. Therefore we can take the principles used in the hamstring tendinopathy post and apply them here. 

What causes an achilles tendinopathy?

There are many risk factors that can lead to an increased likelihood of obtaining an achilles tendinopathy. They are listed below. 

  1. Excessive or repetitive training (inadequate training plan)
  2. Insufficient warm up
  3. Fatigue
  4. Decrease flexibility of the achilles 
  5. Previous history of achilles or related injury (e.g. ankle and knee)
  6. Misalignment and imbalances of the legs. 
  7. Increased age 
  8. Increased BMI 

As with the other injuries cover thus far, there is no one cause of achilles tendinopathy. It’s an overuse injury that is commonly bought on by a multitude of factors. Therefore to prevent it we must address any relevant factors. However the primary concern for people at risk of achilles tendinopathy is training load.
Visit the physio-pedia – Achilles tendinopathy page for more info. 

What is the most effective way to prevent an achilles tendinopathy from occuring?

When looking to prevent any injuries from occuring it’s important to look at the risk factors for the individual. Therefore you would ensure the following is being done to the best prevent injury. 

  1. Structured planning of training with adequate rest and changes in exercise modality (e.g swapping run sessions for bike sessions). Age and weight must be taken into account when planning for an individual. 
  2. Incorporating an appropriate warm up
  3. Building muscle strength and endurance to negate fatigue
  4. Improve achilles flexibility and ankle dorsiflexion
  5. Ensure optimal rehabilitation is done (or was done) after previous injury. 
  6. Address any muscle imbalances or alignment issues. 

When someone is running/jumping the achilles undergoes large amounts of force that cause it to act as a spring. Therefore it’s imperative, no matter the person, that when prevention or rehabilitation is the aim strength training must be involved. 

To listen to more on this topic, go to the Physio Edge podcast and have a listen to all things achilles related. Additionally you’ll find achilles strength training exercises in our runner strength training section of YouTube. 

How do I rehab my achilles tendon?

As with many injuries, rehab and injury prevention are approached in very similar ways. However, prevention can be more broad whereas rehabilitation needs to be specific. Therefore it’s recommended that if you are suffering from an achilles injury, get it checked out by your osteo or other allied health practitioner. Don’t have one? Hit the button below and we can get your rehabilitation journey started. 

Common rehabilitation tools used at the osteo joint

With the above being said there are tools and treatments that we commonly use here at The Osteo Joint. We will run through them with you now. 

  • An achilles strengthening protocal is the first thing that we establish. A baseline of your achilles strength is marked down and we work with you from there to increase to a pre-injury state. 
    Every body with achilles pain will more than likely be prescribe the below exercise at some stage during rehab. It’s the most beneficial exercise. 
  • Managing your symptoms and training load. This means we look to decrease if not completely stop/swap aggravating activities and plan your training accordingly. 
  • Once person is (relatively) pain free, a well managed progressive plan back to full training is implemented. 
  • The use of osteopathic techniques including dry needling. To help decrease tissue tension, increase flexibility and pain in involved areas. 
  • Ensure adequate warm up is done pre-exercise. 

That's a wrap

We hope the above information gave you a clear understanding on what an achilles tendinopathy is, why they occur and how to rehab them most effectively. 
That sees the end of our running injuries series. If there are other injuries you’d like covered, let us know. Alternatively don’t suffer in silence, if you’re in pain all you have to reach out or book in!

Thanks for reading, 
Stay safe, running and injury free. 
Dr Jamey Pemmelaar (Osteo)