Ah the achilles tendon. That big rope-like structure connected to your calf muscle and heel. So useful when things are going well… and oh so crippling when you did just that little bit too much hill running or those 1000 box jumps you did last week. If you have ever felt this pain before and it stopped you from your usual exercise – chances are you had some form of Achilles Tendinopathy.
Achilles Tendinopathy is a common overuse injury of the Achilles tendon and a condition we treat ALOT in the clinic.
What is Tendinopathy?
The widely accepted Cook and Purdum model explains Tendinopathy in 3 stages:
1. Reactive tendinopathy: When compressive or tensile overloading takes place, the tendon thickens and stiffens in attempt to reduce the stress on the tendon.
2. Tendon disrepair: If the tendon is not offloaded and allowed to repair back to stage 1, the tendon cell matrix will start to separate and breakdown physiologically.
3. Degenerative tendinopathy: If the tendon is further overloaded, permanent damage of the cellular makeup will occur.
Tendon change occurs along this continuum and may go back and forth between these 3 stages.
How does overloading occur?
Overloading commonly occurs in the form of:
· Excessive loading through high impact activity such as running or jumping. The Achilles tendon may take loads of up to 2x your body weight when running.
· An increase in training load of high-impact activity or resistance training.
· A return to training after weight gain.
How can improve you improve your Achilles pain?
The key to moving back through the stages of tendon damage needs to follow 2 simple yet crucial steps.
1. UNLOAD – Give the tendon the rest it requires to move back down the stages of damage. This may not be complete rest, but instead a “relative” reduction in your activity e.g. reduce kilometres running by 20%
2. LOAD the tendon to prevent further disrepair. This step requires a careful gradual and progressive loading program which is tailored to the individual’s needs. Rehabilitation with a safe loading can begin straight away and reduces recovery time versus complete rest.
Check out the video below I posted on Facebook for some examples of exercises we use in the clinic to gradually load the achilles tendon during a tailored rehabilitation program.
🏃🏿♂️🏃♀️Your sore achilles needs some LOAD 🏃♀️🏃🏿♂️
One of the key components of any rehabilitation program for achilles tendinopathy is load management.
Sometimes this means backing off some activities initially, but it is necessary to then RE-INTRODUCE load to the tendon!
In this video – Sam Mullany runs us through some examples of exercises we use to progress load on the tendon – and eventually – getting you back to your previous level of activity.
🏋️These exercises should be prescribed EXACTLY in terms of reps/sets and exercise selection i.e with the guidance of a physio!
😧A little bit of pain is OK with these exercises and is often part of the pain desensitisation process
❄️Ice can be used to help modulate pain in between sets of the exercise
😀Your physiotherapist will use exercise in conjunction with addressing overall movement patterns (e.g. pelvis, hip and feet), advising on how much activity you should be doing and muscle/joint release techniques as needed
Posted by Penrith Physiotherapy Sports Centre on Sunday, December 2, 2018
If you need help managing your Achilles pain pop in to see Sam Mullany at the practice. You can make a booking with him online or by calling 4721 5567