Achilles Tendinopathy
Blog by Tolis Sassanis, Senior Physio.
What is the Achilles tendon?
A tendon attaches muscles to bone. The Achilles tendon connects the gastrocnemius and soleus muscles (calf muscles) to the heel bone (calcaneus). It is the thickest and strongest tendon in the human body. The contraction of the gastrocnemius and the soleus muscles results in a translational force through the Achilles tendon that results in plantar flexion of the foot (helps you go onto tiptoe) responsibility for actions as walking, running and jumping.
What is Achilles tendinopathy?
Achilles tendinopathy is a condition that can cause pain, stiffness, swelling and weakness of the Achilles tendon, usually due to overuse and excessive chronic stress upon the tendon. It can affect both athletes and non-athletes. Any sports or activities that put stress on the Achilles tendon such as football, rugby, volleyball, basketball, tennis and running can lead to Achilles tendinopathy.
What are the symptoms of Achilles tendinopathy?
• Tenderness over the Achilles tendon.
• Stiffness in the tendon - often worse first thing in the morning or if you've been resting for a while.
• Variable pain - it can range from a mild ache to severe pain.
• Swelling (less common)
Diagnosis
Diagnosis can be made by your GP or physiotherapist, it is not always needed to carry out X-rays or scans.
Physiotherapy for Achilles tendinopathy
Achilles tendinopathy can be treated with Physiotherapy that includes specific exercises, manual therapy, electrotherapy modalities, stretching, education and advice.
Self help for Achilles tendinopathy
• Rest by reducing physical activity
• Cryotherapy- apply cold pack or ice wrapped in a towel.
• Take over the counter pain killers unless advised to the contrary by a GP.
Exercises for Achilles tendinopathy
We recommend that you see a Physiotherapist to confirm diagnosis before attempting these exercises. Chichester Physio Ltd take no responsibility for any injury caused by attempting these exercises.
Less burdening activities should be encouraged so the burden on the tendon decreases, however, complete immobilisation should be avoided since it can cause atrophy. The key goal of the tendinopathy treatment is to improve the energy storage capacity of the tendon progressively. Please see the video opposite to help with these exercises.
• Phase 1 - Isometric Exercises
1. Bilateral calf raise with straight knees 3× 10 seconds hold
2. Bilateral calf raise with bent knees 3x 10 seconds hold
*if pain level <5/10 progress to:
3. Unilateral calf raise with straight knee 3× 10 seconds hold
4. Unilateral calf raise with bent knee 3× 10 seconds hold
• Phase 2 - isotonic exercises
1. Bilateral calf raise with straight knees 3x10 seconds hold
2. Bilateral calf raise with bent knees 3×10 seconds hold
*if pain level <5/10 progress to:
3. Unilateral calf raise with straight knee 3×10 seconds hold
4. Unilateral calf raise with bent knee 3×10 seconds hold
• Phase 3 - plyometric exercises
1. Jumping-landing 3×10
2. Jogging on a spot - start with 1 min Jogging then one min walking and repeat 10 times
3. Hopping - start with 3 repetitions and build up progressively.