Achilles Tendinopathy
What is this condition? What causes this condition?
A condition appearing in the tendon that joins the heel to your calf muscles in the ankle region. Commonly thought to occur due to over use and repeated little tears of the achilles tendon. The Achilles is important as it assists in bending foot downwards at the ankle joint. There are 3 degrees of severity of achilles tendinopathy –
Mild- pain during an activity such as running
Moderate- the achilles tendon may swell, a hard lump may form in the tendon
Severe- A type of activity where weight bearing causes pain, sometimes the tendon can fully rupture.
Causes of the condition is due to overuse where the tendon can degenerate over time. There can be issues due to feet, especially in people with flat feet as the flat arch of the foot as strains to the Achilles tendon. Being excessively overweight can make all these problems significantly worse.
Common symptoms / signs
– Pain
– Swelling
– Stiffness
– Exercising in incorrect footwear
– Pain is generally worse in the morning
Risk factors of this condition?
o Age (van der Vlist et al., 2019)
o Limb alignment issues
o Participating in new exercises
o Wearing inappropriate shoes
o Medications
o Overweight/obesity
o Reduced planter flexion and dorsi flexion strength
How is it treated?
Rest is a common treatment. Firstly, stopping any high load or high impact activities is important. In addition to rest pain killers can be used such as paracetamol or ibuprofen. If in the early stages of the condition ice can commonly help to reduce swelling, the ice assists in reducing blood flow to the area.
As pain reduces it is important to begin strengthening and stretching exercises, this includes a knee to wall calf stretch (completed daily), eccentric calf raises, calf raises on a box, calf stretch using towel for assistance, dorsiflexion of toes in seated position (Alfredson & Cook, 2007).
Other causes/differential diagnoses
Other uncommon treatments include shock wave therapy, where sound waves are passed over the tendon, at the moment there is a variety of evidence and is not fully supported due to side effects of rupturing the tendon. Another uncommon treatment includes injection using your own blood, this promotes healing of the tendon and increases cell growth. There are still discrepancies in evidence for both treatments.
References
Alfredson, H., & Cook, J. (2007). A treatment algorithm for managing Achilles tendinopathy: new treatment options. Br J Sports Med, 41(4), 211-216. https://doi.org/10.1136/bjsm.2007.035543
van der Vlist, A. C., Breda, S. J., Oei, E. H. G., Verhaar, J. A. N., & de Vos, R.-J. (2019). Clinical risk factors for Achilles tendinopathy: a systematic review. Br J Sports Med, 53(21), 1352. https://doi.org/10.1136/bjsports-2018-099991