What is Achilles Tendinopathy?

Achilles tendinopathy is where the tendon that connects the calf to the back of the heel becomes thickened, weak, and painful. This results in localised pain, typically worse after activities. Running and jumping will be sore, as well as walking if the condition is considerably aggravated. 

What causes it?

Like most tendinopathies, it tends to present itself when things change. For example, we decide we want to start increasing our running volume, quite rapidly. Tendinopathies are a result of the body adapting, struggling to manage unsustainable loads.

How do we fix it?

Strength and training is the primary medium to fix tendinopathies. We need to strengthen our tendon to undo this process that has left it weakened. In the short term treatments such as taping, massage, ice, and heel lifts can assist with pain management. In the longer term, it is essential we develop a progressive loading program to condition us back into activity.

This idea of load management is critical. Typically with Achilles tendinopathy, we tend to think in volume. How much are we doing per week, and what types of activities? Generally, activities where the Achilles works as a spring – such as running and jumping, tend to be the most provocative, especially if sprinting is involved. The goal is to identify the most that we can do, without our pain flaring up, and then to progressively build from that stage.

Stretching typically tends to be unhelpful with Achilles tendinopathy – it will often worsen the problem in the early stages.

A great initial exercise to try is an isometric heel raise – that is, standing up on the toes of two feet, holding the position for 30 seconds, repeating up to 5 times. This cannot cause more than mild pain, in order to be effective.

If managed incorrectly, Achilles tendinopathy can be a very slow condition to recover. If you think this applies to you, please come in for an assessment so we can establish a plan for your recovery.

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