The Achilles tendon is the large tendon situated behind the ankle connecting the calf muscles to the heel bone. Its primary function is in allowing push off in running and walking activities. The mechanism of injury may be linked to a sudden increase in the intensity or frequency of training and the severity may be graded out of four. It is characterised by local pain and swelling with tightness that improves with activity.
We used to think that ongoing pain in the Achilles – achilles tendonosis – was caused by inflammation; however we now know that this condition is caused by an aging process within the tendon. It is most common in male runners in their 40’s and 50’s, but also occurs frequently in women and in people who do not exercise. The condition can be very debilitating and in the past has been hard to treat.
No-one is quite sure why some people suffer with this problem however it is more common in people who:
• Run a lot
• have flat feet
• have weak calf muscles
• have stiff feet and ankles
• wear poor quality running shoes
Recently there has been a lot of research into a very specific exercise regime to progressively stress and remodel the tendon. It has shown encouraging results over a twelve week period that has long lasting effects.
Injury prevention strategies for this injury include appropriate footwear for cushioning and controlling foot posture. Allowing recovery time in training intervals. Adequate warmups and cool downs. Avoiding hard training surfaces. Ensuring good strength, flexibility joint range and balance and co-ordination. Taping support for the soft tissue structures. Staying hydrated and with good nutrition. Always follow the advice of your health professional.
In addition to this exercise program the most effective treatment for achilles tendonosis is currently thought to include;
• a program to stretch the muscles of the calf
• assess biomechanics and correct excessive foot motion using tape or orthotics to reduce unnecessary forces through the tendon.
• activity modification and shoe assessment
• soft tissue treatment to muscle spasm (trigger points) and areas of fibrosis to increase the flexibility and protective abilities of the muscles.