What is the Achilles?
Your Achilles is a tendon that connects the muscles of your calf to the back of your heel. The Achilles tendon is the biggest and strongest in the whole body.
What is the role of Achilles?
The Achilles tendon is involved in plantarflexing (planting your foot, i.e. pushing on the accelerator in your car) the foot. This is a crucial body movement for functions such as walking, running and jumping. The Achilles tendon plays a big role in producing explosive power and can produce force 10x your body weight.
How common is Achilles' pain?
The Achilles tendon is susceptible to damage with repetitive use or overload. These types of injuries typically occur in athletes and are usually sports or exercise-related.
The most common diagnosis of Achilles pain is Achilles Tendinopathy (which accounts for about 55-65% of cases - Järvinen 2001). You can also rupture your Achilles However, it is quite rare, being such a strong tendon.
Common symptoms
Pain in your heel or Achilles tendon
Morning pain - This is an extremely common symptom
Pain following activities (immediately after or the next day)
Difficulty walking/planting your foot
Swelling, tenderness and even warmth of the Achilles tendon
Common Symptoms Achilles Pain
Difficulty walking/planting your foot. Swelling, tenderness and even warmth of the Achilles tendon
What can be the causes?
The most frequent reason patients seek us out in our studio is that they have done too much excersice, too soon. This is usually something you see in longer-distance activities like running or bush walking when patients haven’t previously done these activities in a while or ever!
Overpronation or ‘flat-feet’ can be another cause of Achilles pain as greater demands are placed on the Achilles tendon. Over-pronation can also lead to Achilles pain due to a lack of blood flow in that position, leading to injury (Karzis, et al, 2017). Overpronation can initiate an inflammatory response to the Achilles tendon and potentially begin an Achilles tendinopathy
Treatment Techniques
Manual Therapy
For those patients with acute or chronic Achilles pain, a range of manual therapy techniques may be used to help decrease their level of pain, improve their range of motion and improves function. This can include massage, trigger pointing, dry-needling and many more techniques.
This is a significant variable of how we treat as physiotherapists but it has an even greater effect when paired with strength and conditioning for the Achilles.
Load Management
If a key contributor to Achilles tendon pain is overloading the tendon, managing those loads is an obvious direction for treatment. Recognising current loads for our clients is crucial in the advice we give to help manage those loads.
Your Physiotherapist has a great understanding of how much force is needed to complete a task related to the Achilles tendon. Therefore, your physiotherapist can help guide you with what exercises you can still complete without overloading the tendon. Once symptoms settle, this is when we can look to increase our loading with a range of different exercise approaches.
Strength
Strengthening our Achilles is crucial in building a greater load tolerance. The more load the Achilles can tolerate, the less chance of that tendon being overloaded. These are very much based on calf-based exercises which can progress to more impact-based movements like jumping and hopping.
If you want to know more about Achilles pain, treatment or rehab,
BOOK HERE with one of our physiotherapists.
References:
Järvinen TA, Kannus P, Paavola M, Järvinen TL, Józsa L, Järvinen M. Achilles tendon injuries. Current opinion in rheumatology. 2001 Mar 1;13(2):150-5.
Karzis K, Kalogeris M, Mandalidis D, Geladas N, Karteroliotis K, Athanasopoulos S. The effect of foot overpronation on Achilles tendon blood supply in healthy male subjects. Scand J Med Sci Sports. 2017 Oct;27(10):1114-1121. doi: 10.1111/sms.12722. Epub 2016 Sep 27. PMID: 27671520.
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