What is Achilles Tendinopathy?
The Achilles tendon is the tendon that attaches the calf muscles to the heel. Pain in this tendon is called Achilles tendinopathy. The Achilles tendon is a vital part of transmitting load and force up from the foot and ankle to the rest of the lower extremity and it serves dual purpose to absorb shock from the lower extremity.
What causes Achilles Tendinopathy? What are common symptoms?
Achilles tendinopathy often occurs when the foot and ankle experience excessive loading, such as a sudden increase in training volume or a change in activities that require the tendon to work differently then it is used to. This can occur seemingly ‘out of the blue’ or suddenly during an activity that requires an explosive effort.
Common symptoms include:
- Pain to touch or squeeze the Achilles tendon
- Swelling and thickening in the area of pain
- Pain when rising up onto your toes, such as when walking up stairs
- Pain during running and jumping activities
How can Physiotherapy help my Achilles Tendinopathy?
Your Strive Physiotherapist can help to treat both the direct causes of your pain, as well as contributing factors to why it developed in the first place. Your physiotherapist will employ manual therapies such as massage to the muscles of your calf and joint mobilizations to the bones in the foot and ankle, and potentially modalities such as Shockwave therapy.
You will be given a tailored exercise program to help strengthen the muscles contributing to your symptoms and get you back to your regular activity. Your Strive Physiotherapist will help you determine how much you find the right balance of challenging the Achilles tendon with work to promote healing without overdoing it. If your pain is due to a running injury, a gait analysis can be done and advice given on technique, training errors and footwear can be provided.
How can a Pedorthist help my Achilles Tendinopathy?
A Pedorthist can assess how your lower leg and foot move and adapt to different surfaces, shoes and activities. Your Strive Pedorthist can perform a gait and running analysis and give you advice on the type of footware that will best suit your foot and the activities you like to do. In some cases, custom orthotics may be recommended to provide your foot and lower leg with improved support
How can Massage Therapy help my Achilles Tendinopathy?
Massage therapy can also be used to treat both the direct and indirect causes of your Achilles tendinopathy pain. Your Strive Massage Therapist will work on a broader area of muscles contributing to your symptoms, helping to reduce tightness through the calf, hips, and lower back that are contributing to your pain.
Massage therapists are also skilled in various neuromobilization techniques which may be underlying your ankle pain and are an important component to your recovery. At Strive we work as a team. Your Strive Massage Therapist will communicate with your Physiotherapist to ensure both members of your team are working together to help you get back to your normal.
How can Sports Medicine/Physiatry help my Achilles Tendinopathy?
In most cases, the conservative management described above is extremely effective in helping you to overcome the symptoms of your Achilles tendinopathy and get back to your regular activities pain free. However, in some cases you may need to see a Physiatrist and/or a Sports Medicine Physician for medication or an injection to assist with pain relief.
Both your Physiatrist and Sports Medicine Physician can order imaging such as an ultrasound or x-ray to determine if there may be a small tear or bone spur that is slowing down the healing process. Sports Medicine Physicians use ultrasound guidance to perform various specialized injections such as cortisone and Platelet Rich Plasma (PRP) and provide medications both oral and topical.
How long does it take for me to recover from my Achilles Tendinopathy?
For someone with Achilles tendinopathy, it typically takes around 3-6months until they feel that they are ‘back to normal’. It starts with a progressive strengthening program that increasing the activities your tissues can tolerate, for the same amount of pain. As you get stronger, the pain decreases and your tissues can continue tolerate more load, which means you can do more!
It’s a long process, BUT if you commit to your journey, you will have the strategies to not only manage your pain in the short term but self-manage any recurrences of this pain down the road.
What are the best exercises to help with my Achilles Tendinopathy?
To get started with some exercises to address your achilles tendinopathy, check out the Achilles Tendinopathy Home Exercise Program.
Please keep in mind that these exercises were designed as a place to start to address your symptoms. These exercises should not be performed or continued if they cause or increase your pain in any way. Using these exercises for self-management of your symptoms does not replace the value of being assessed by a Health Professional. If you find you need help, let a Strive Health Professional help you, book your time today!
What can I do to treat Achilles Tendinopathy at home?
Avoid doing the things that aggravate your symptoms.
- For example, if you notice that every time you go for a long walk or run your pain is worse after, you may need to decrease your walking or running mileage to allow the tissues time to recover. Choosing exercises that involve less weight bearing like swimming or biking can be a positive alternative for some. Decreasing the load and providing some rest will allow time for you to build up the strength in the appropriate muscles prior to returning to your activity.
Self-massage or foam rolling to the muscles of your calf. For runners, modify activities to keep up your cardiovascular endurance during your rehabilitation period. This could mean replacing your running with biking so that when your Achilles is ready to return to training so is the rest of your body!
Written in 2020 by Kiah Brubacher-Cressman, Registered Physiotherapist
Danna Epstein Marcus
BHSc, MScPT, Dip.Manip.PT
Danna Epstein Marcus has formal training in dance including ballet, pointe, jazz, lyrical, and tap. She has extensive training in dance rehabilitation in areas including pre-season and pre-pointe assessments, assessment and treatment of dance injuries and hypermobility disorders, establishing safe warm up and stretching routines, dance specific exercise rehabilitation including core stability, strategies to improve turn out, arabesque, développé, and other dance specific techniques. She is a member of Healthy Dancer Canada.