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ACHILLES TENDINOPATHY

2016/06/20 Home Education and advice

ACHILLES TENDINOPATHY

The Achilles tendon is located behind the ankle, connecting the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). When the calf muscles contract, the Achilles tendon tightens and causes the foot to bend into a pointed position. While the Achilles tendon is essential for simply standing upright, it is particularly needed when practicing activities that involve running or jumping.

Achilles tendinopathy is a condition that occurs when excessive repeated stresses applied to the Achilles tendon cause pain and sometimes swelling behind the ankle. This pathology consists of a degeneration of the tendon’s microscopic fibers which occurs when mechanical stress overloads the tendon’s capacity.

Possible causes of Achilles tendinopathy

Overload arising from a new physical activity (e.g. starting to run)Overload arising from a parameter change (e.g. changing shoes, increasing the running distance)
Reduction in the strength or flexibility of the calf musclesChanges in foot posture

Achilles tendinopathy involves different stages of degeneration of the tendon’s fibers. The more the degeneration progresses, the more difficult it becomes to reverse changes in the fibers. Early intervention provides a better rehabilitation prognosis.

How can the physiotherapist intervene?

– Identify and correct the factors that have contributed to the development of the condition by changing or temporarily stopping activities.
– Exercise program with eccentric strengthening of the calf muscles to gradually increase the tendon’s capacity to support loads. These exercises stimulate collagen production to strengthen the tendon.
– Corrective exercises for muscular imbalances and posture problems.
– Techniques for soft tissues, manual therapy and electrotherapy.

Your physiotherapist at Kinatex will design an individualized treatment plan and guide you to a gradual return to your favourite sports to optimize your performance, injury-free.

References

¹ Malliaras P, Barton C, Reeves N, Langberg H. Achilles and Patellar Tendinopathy Loading Programmes: A Systematic Review Comparing Clinical Outcomes and Identifying Potential Mechanisms for Effectiveness. Sports Med (2013) 43:267–286.

² Wiegerinck JI, Kerkhoffs GM, van Sterkenburg MN, Sierevelt IN, van Dijk CN. Treatment for insertional Achilles tendinopathy: a systematic review. Knee Surg Sports Traumatol Arthrosc (2013) 21:1345–1355.

³ Brukner P, Khan K. Brukner and Khan’s Clinical Sports Medicine 4th edition McGraw Hill, Sydney 2012.