Achilles Tendinopathy (Tendinitis of the Heel)

What is Achilles tendinopathy?

When your achilles tendon becomes sensitive, painful, and sometimes even swollen as a response to being overloaded or not given enough time to adapt. The Achilles tendon is the strongest and thickest tendon in the body which can manage huge stresses including loads of multiple times your body weight. Common symptoms include early morning sti­ffness/pain and pain when moving after being inactive.  

 

What are the causes?

A recent increase in physical activity, such as running. This could be the total distance, frequency, speed, or adding in hills. Muscle imbalances, tightness and weakness may also contribute.

 

How do you treat Achilles tendinopathy?

By creating the right environment for the body in terms of activity levels and recovery allowing it to adapt and to settle symptoms. We can achieve this by modifying or reducing painful activities to a level the Achilles tendon can manage (load management). We recommend consulting your local health professional for advice regarding appropriate footwear and a graded exercise program to prevent recurrence.

 

What exercises are good for Achilles tendinopathy?

Isometric calf exercises can be beneficial, especially in the early stages while your achilles tendon is irritable. Isometric exercises are essentially contracting the muscle without movement, therefore reducing the aggravating stretch on your tendon. As your pain levels reduce, calf strengthening can be progressed to include heavy, slow resisted exercises and eventually more explosive plyometrics to help increase your Achilles tolerance to load.

 

What should I avoid?

Doing too much too soon, especially when it comes to running or jumping as these place high levels of force on the Achilles. Stretching the calf/achilles may feel good in the moment but tendons are actually sensitive to being overstretched so this may further exacerbate your symptoms. If your calf is tight I would suggest foam rolling as an alternative as this won’t stretch the Achilles.

 

How long does it take to heal?

Recovery timeframes vary from person to person although you should see some significant improvement within the first 2-4 weeks of load management. Depending on how long you have had it for and if it is a recurring issue, symptoms may persist for up to 3-6 months.

 

Is it okay to exercise with Achilles tendinopathy?

As a general guide it is okay to exercise with pain provided it is mild, not affecting the way you walk/run (e.g. limping) or is still sore 24 hours later. Exercising with a mild level of pain that recovers by the next day can actually help make you foot and ankle more robust over time. However, I recommend that you seek the experience of a professional to assess your ankle and provide you with clear advice and a rehabilitation program tailored to you rather than Googling your way through rehab!

If you would like someone to help make sense of your pain, please call us at (02) 8411 2050. At Thornleigh Performance Physiotherapy, we can give you an accurate diagnosis and treatment, to help you get back in action as soon as possible. We are conveniently located near Beecroft, Cherrybrook, Hornsby, Normanhurst, Pennant Hills, Waitara, Wahroonga, Westleigh, West Pennant Hills, and West Pymble.