achilles tendinopathy

The Achilles tendon, also known as the Calcaneal tendon, serves to connect the muscles of the calf (the gastrocnemius and soleus) with the bone of the heel (the calcaneus). The Achilles tendon is the strongest in the body, and contributes to the generation of force during activities such as walking, running, and jumping. 

Achilles Tendinopathy is a condition where the Achilles tendon becomes stiff, swollen, and painful. This condition occurs when the tendon is exposed to microtraumas, or "mini injuries". This can occur with overuse of the tendon, or as a result of improper footwear or exercise form. Inadequate recovery time between microtraumas may also contribute to the development of Achilles Tendinopathy. 

symptoms

  • Painful, swollen, and stiff Achilles tendon
  • Increased pain after exercise 

causes

  • Overuse
    • Ex. Dancing
  • Trauma to the tendon/heel/ankle
  • Inappropriate footwear
  • Improper exercise form and technique
  • Abrupt changes in training (i.e., sudden increase in training volume or modality)

treatment

  • Rest
  • Painkillers (Ibuprofen or other NSAIDs)
  • Ice treatment
  • Physiotherapy 
    • Specialized Achilles tendon/calf exercises 
    • Shockwave therapy
  • Orthotics
  • Surgery for severe/persistent cases

HOW DOES PHYSIOTHERAPY HELP?

  • Adherence to a specialized exercise program can be particularly helpful in the recovering from Achilles Tendinopathy and minimizing symptoms.
    • Beneficial in preventing muscle atrophy and loss of motion due to immobilization
    • Help improve posture and exercise form to prevent reinjury of the tendon and support recovery.
  • Ice therapy (10-15 minutes at a time, a few times a day) can help relieve swelling and pain in the heel
  • Intramuscular stimulation (IMS) may help promote relaxation of the calf muscles to relieve excess/residual tension in the tendon.
  • Recent research suggests that Shockwave therapy can be particularly helpful in treating Achilles Tendinopathy, by improving function and minimizing pain
    • The benefits of Shockwave therapy are enhanced by a personalized exercise and stretching program
  • Physiotherapy is also beneficial in post-surgical recovery in promoting healing and strengthening the supporting musculature