The Achilles tendon is the longest tendon in the body and is one of the most troublesome for causing pain and being injured. The Achilles tendon pathology is a challenge for both the Specialist Physiotherapists and their clients to get treated and to get back to full, normal activity pain free. Pain is located at the back of the ankle on or just above the heel and is characteristically worst first thing in the morning.
Like most tendons the Achilles tendon does not adapt quickly to the sudden changes in the demands we can put on it during running, walking or explosive sports. Individuals over the age of 35 are more vulnerable to tendon pain due to the natural ageing process within our bodies. There are a few systemic illness that predispose individuals to tendon problems too e.g. thyroid problems
The jobs of the Achilles tendon are to attach muscle to bone, to store energy and transmit load/forces. The Achilles tendon does not have a fantastic blood supply making it more vulnerable to change and more stubborn to get back to normal, which is why we all know the name of the Achilles tendon.
Sudden changes in how much we ask the tendon to work e.g. increasing the distance or speed we run or walk, does not allow the tendon enough time to adapt to these increased workload. This results in disorganized tendon tissue, an increase in fluid within the tendon and subsequent pain.
Term to describe this is Achilles Tendinopathy, which just means there is something wrong with the tendon.
Apart from increased loading during training/running without adequate periods of recovery and adaptation time, there can be other factors that increase the likelihood of your Achilles tendon starting to become painful due to an indirect increase in load:
Poor footwear not adequately supporting the arches in the foot
An increase in hill running or walking
An increase in your weight
A change in training terrain to more uneven and or harder ground surfaces
Loss of bounce/resilience in your footwear
Carrying a backpack
Changing footwear eg to flat shoes or flip flops
Tendons take 3 months for the tendon the completely turn over new tendon tissue naturally. I would observe that most people put up with unhappy tendons for several weeks to months before seeking professional advice, thinking and hoping it will just get better on its own. This leads to frustration and disappointment as progress in fitness aims are sidelined eventually.
An early assessment by your Experienced Physiotherapist will allow for appropriate advice regarding factors influencing your specific set of circumstances, give you some treatment for pain relief and start you on an adequate and appropriate loading programme specifically tailored to your needs. Let us help get your Achilles tendon back on track!
Recent evidence has moved away from stretching for unhappy tendons and different approaches of rehabilitation work better for the different areas of your Achilles tendon that can cause you problems. We can help work out the best plan forward for you.
The Specialist Physiotherapists here at Jill Kerr Physiotherapy located within Therap-Ease in Morningside, Edinburgh can help get you back on track with your Achilles tendon. Remember we aim to “Treat you Better”.
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