Achilles tendinopathy (formerly known as “Achilles tendinitis”) refers to an overuse injury of the Achilles tendon, a strong band of connective tissue that connects your calf to the back of your heel bone. There is degeneration or wearing out of the tendon fibres. The degeneration often involves disorientation and thinning of the normally strong tendon fibres.
It often starts in sports that involve running. In severe cases pain can be felt even with walking. It commonly appears in runners who have suddenly increased the intensity or duration of their runs.
Do you know that sensation of burning in your muscles that you get after a big workout? Achilles tendinopathy may feel like that. The difference is that with tendinopathy the pain may get worse after a period of rest or reappear as soon as you start your next workout. Pain is usually present at the beginning and end of a training session, with a period of “warming-up” or reduced pain in between.
Physiotherapy plays a vital role in rehabilitation and recovery of patients with Achilles tendinopathy. The most essential and proven treatment that predictably improves pain and function in patients with this injury is what is known as “eccentric strengthening programme” (this is also known as “Alfredson program”). Your physiotherapist usually prescribes these exercises to you and explains how to do them. A number of clinical studies have proven the effectiveness of this Achilles eccentric strengthening. One such study done in 2004 in Sweden has shown that performing these exercises for 6 weeks reduced pain associated with Achilles tendinopathy by as much as 27%.4 There was also further improvement at 1-year follow-up assessment.
Other forms of treatment include:
- autologous blood injections,1
- night splints,
- shock wave therapy.
Out of these three therapies only the effectiveness of shock wave therapy has been proven in scientific research.3 Use of foot orthotics may be another useful add-on to your Achilles tendinitis treatment and rehabilitation programme.2
Icing the Achilles area just above your heel may help to reduce some of the pain. It may also help to insert a small heel raise (or heel wedge) in your running shoe. This helps to take some strain off the Achilles when running.
In any case we recommend that you see your health practitioner for advice on addressing this problem. At Growing Younger we see patients with this condition on a regular basis and will be happy to help you too. If you’re looking for physiotherapy in Howick or Mt Wellington call us on the number above to book your physiotherapy consultation at either of our two clinics. Our friendly team will instantly book an appointment for you to have this problem sorted.
- Br J Sports Med. 2014 Sep;48(17):1334. doi: 10.1136/bjsports-2013-f2310rep.
Republished research: Impact of autologous blood injections in treatment of mid-portion Achilles tendinopathy: double blind randomised controlled trial.
Bell KJ1, Fulcher ML2, Rowlands DS3, Kerse N2.
- Sports Med. 2014 Aug 10. [Epub ahead of print]
Effectiveness of Orthotic Devices in the Treatment of Achilles Tendinopathy: A Systematic Review.
Scott LA1, Munteanu SE, Menz HB.
- Am J Sports Med. 2014 May 9. [Epub ahead of print]
The Effectiveness of Extracorporeal Shock Wave Therapy in Lower Limb Tendinopathy: A Systematic Review.
Mani-Babu S1, Morrissey D, Waugh C, Screen H, Barton C.
- Scand J Med Sci Sports. 2004 Oct;14(5):286-95.
Clinical improvement after 6 weeks of eccentric exercise in patients with mid-portion Achilles tendinopathy — a randomized trial with 1-year follow-up.
Roos EM1, Engström M, Lagerquist A, Söderberg B