Understanding Achilles Tendinopathy: Causes, Symptoms and Treatment
Whether you’re a seasoned athlete, a weekend warrior, or someone who enjoys regular physical activity, understanding Achilles tendinopathy is key to preventing and treating this condition. In this blog, we’ll explore the causes, symptoms, and effective treatments for Achilles tendinopathy to help you understand and manage this condition.
Achilles tendinopathy is an overuse injury that leads to damage and degeneration of the Achilles tendon. Unlike an Achilles tendon rupture, which involves a tear, tendinopathy involves the tendon becoming irritated, inflamed, and thickened. It’s commonly categorised into two types:
- Non-insertional Achilles Tendinopathy: This occurs in the middle of the tendon, often affecting individuals who are active in sports or repetitive activities.
- Insertional Achilles Tendinopathy: This type affects the lower portion of the tendon, where it attaches to the heel bone. It’s often seen in people who engage in activities involving a lot of running or jumping, as well as those with flat feet or poor foot mechanics.
Causes of Achilles Tendinopathy
Achilles tendinopathy is usually the result of repetitive stress on the tendon, which leads to tiny tears and degeneration over time. Some common causes include:
- Overuse: Engaging in high-impact or repetitive activities like running, especially without proper warm-up or rest.
- Sudden increase in activity: Rapidly increasing intensity, duration, or frequency of exercise, such as running longer distances or increasing training volume too quickly.
- Biomechanical issues: Flat feet, high arches, or improper footwear can increase the stress on the Achilles tendon, making it more susceptible to injury.
- Tight calf muscles: Tightness in the calf muscles puts added pressure on the Achilles tendon, leading to potential overuse.
- Age: As we age, our tendons lose some of their elasticity, making them more vulnerable to injury.
- Previous injury: A history of Achilles injuries increases the likelihood of developing tendinopathy.
Symptoms of Achilles Tendinopathy
The symptoms of Achilles tendinopathy can range from mild to severe and often develop gradually. Common signs include:
- Pain and stiffness: Pain usually develops in the back of the lower leg or heel. It can be more pronounced in the morning or after periods of rest and may subside as you begin moving.
- Swelling and thickening: The tendon may appear swollen, and the affected area may feel thickened or nodular to the touch.
- Pain with activity: You may experience pain when walking, running, or performing activities that involve pushing off the ground with your feet.
- Tenderness: The Achilles tendon may be tender to the touch, especially around the affected area.
- Reduced range of motion: It may become difficult to point the toes downward or fully extend the ankle due to pain or tightness.
Treatment for Achilles Tendinopathy
Treating Achilles tendinopathy primarily involves a combination of conservative management strategies. Here are some common treatment options:
- Rest and Activity Modification: The first step is to reduce or modify the activity that is causing stress on the tendon. This may mean taking a break from running or high-impact exercises and opting for low-impact alternatives like swimming or cycling.
- Ice and Anti-inflammatory Medications: Applying ice to the affected area can help reduce swelling and pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be used but should only be taken under the guidance of a healthcare provider.
- Physical Therapy: A physical therapist will guide you through exercises to strengthen the calf muscles, improve flexibility, and address any biomechanical issues contributing to the tendinopathy. Eccentric strengthening exercises, where the muscle lengthens while under load, have shown to be particularly effective in treating Achilles tendinopathy.
- Footwear Adjustments: Supportive shoes or orthotic insoles may help alleviate pressure on the Achilles tendon, particularly if you have flat feet or other alignment issues.
- Taping or Bracing: In some cases, taping techniques or a brace can provide additional support to the tendon during physical activity.
Prevention Tips for Achilles Tendinopathy
Preventing Achilles tendinopathy involves maintaining a balanced approach to training and taking care of your body. Here are some tips to help you avoid this condition:
- Warm-up properly: Before engaging in physical activity, warm up with dynamic stretching or light aerobic exercises to prepare your muscles and tendons.
- Progress gradually: Avoid sudden increases in intensity or duration of exercise. Gradual progression allows your tendons to adapt to the increasing demands placed on them.
- Strengthen your calves: Regular calf-strengthening exercises can improve tendon resilience and reduce the risk of injury.
- Wear proper footwear: Invest in shoes that provide adequate support and cushioning. Consider custom orthotics if you have flat feet or other structural issues.
Conclusion
Achilles tendinopathy is a common yet manageable condition that can affect anyone, particularly those involved in physical activities. With proper care, treatment, and attention to prevention, most people recover and return to their normal activities. If you suspect you have Achilles tendinopathy, don’t hesitate to contact us to get an accurate diagnosis and develop a treatment plan tailored to your needs. Stay active, stay safe, and listen to your body!
Dylan McDonald (Podiatrist)