Achilles tendinopathy is an unfortunately common complaint seen in a physiotherapy clinic. Achilles tendon pain is usually due to small tears in the tendon which can develop over time. This may occur due to a single incident of overstretching or straining the tendon, or through general overuse where the tendon becomes worn and damaged.
Several factors can contribute to the development of Achilles tendinopathy. These include:
- Wearing high-heeled shoes that shorten and tighten the calf muscle
- A sudden increase in the amount of training or walking
- Poor footwear that rub against the tendon or do not support the foot adequately
- Training on hard or uneven surfaces – beach running and running up hills is notorious for this
- Insufficient stretching or recovery between training sessions
- Poor foot biomechanics – excessive pronation is the most common
- Weight gain
Achilles symptoms include pain in the Achilles tendon, heel or lower calf. Tenderness to pressure and redness and swelling are common. There may be difficulty rising up onto your toes, particularly when standing on 1 leg only.
Early physiotherapy treatment for this problem is vital as it can become difficult to resolve the longer it has been there. Full rehabilitation is important to achieve an optimum outcome and prevent reoccurrence.
Treatment may include:
- Correction of foot biomechanics – advice on footwear and/or the prescription of orthotics.
- Loosening of muscle and joint structures that may be impairing or altering normal movement of the calf muscles and ankle joint. This may include mobilizing or manipulating the bones of the ankle and the foot as well as stretching and releasing the muscles of the calf.
- Strengthening program to prevent re-injury