Achilles Tendon injuries are common amongst runners and active people. The Achilles tendon is the longest tendon in the body and attaches the calf muscles to the foot. It is active in providing stability as the foot lands in the early contact phase of gait and in propulsion as the foot leaves the ground. In runners it is subject to very high loads so is vulnerable to overuse type injuries.
How does the tendon get injured?
The injury occurs when the breakdown of collagen fibres in the tendon occurs at a greater rate than the body's ability to regenerate. This happens where there is repetitive loading and stress on the tendon over time due to factors such as overtraining, a change in running style without sufficient adaptation over time, or weakness in other muscle groups leading to an increased workload on the tendon.
How do I know if I've got it?
The signs and symptoms of Achilles Tendinopathy are pain, swelling and stiffness in the Achilles Tendon, usually at about the mid-section of the tendon. Pain and stiffness can be felt during exercise, but generally hurts up to 24 to 48 hours after loading.
Do I need to stop running and rest it?
In the very early stages rest from exercise can help to ease symptoms. However tendons don’t like to be rested for too long so early mobilisation in a controlled way is key in the first stages of rehabilitation.
High impact exercise such as running and jumping should be avoided if tendon pain is more than 4/10 on a scale of 1 to 10 in a 24 to 48 hour period after exercise. At this stage low impact cross training such as cycling, swimming or pool running is important to maintain aerobic fitness and mobilise the tendon without overloading it.
The secret to quicker recovery with Achilles Tendon problems is managing load through the tendon, making sure the tendon is not ‘overloaded’ or ‘underloaded’. This can be tricky to get right so in most cases some professional help will be needed to properly manage the injury and speed up the healing process.
How can a Podiatrist help?
A typical Sports Podiatry management plan will consist of the following:
- Controlled rehabilitation exercises such as heel drops under supervision to strengthen and rehabilitate the tendon.
- A course of clinic therapy sessions to optimise recovery of the tendon and relieve pain.
- Identification and treatment of any biomechanical issues such as excessively tight calf muscles or weakness in other muscle groups which may be contributing to abnormal loading of the tendon.
- Assessment of running gait to identify any issues with running technique which may be overloading the tendon.
Remember that prevention is better than cure so warm ups before exercise, warm downs after exercise, and avoiding overtraining, or 'too much too soon', will all help to reduce the risks of this frustrating injury from occurring in the first place.
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