Achilles Tendonitis

Are you a keen runner, hiker or athlete? Do your movements feel restricted due to Achilles tendonitis pain in the back of your lower leg that radiates upwards during exercise and activity? As an experienced physiotherapist, I'm here to help!

Let me give you some understanding of this injury; from some common causes and symptoms to advice on how to prevent it so that you can get running again, pain-free!

What causes Achilles tendonitis

Achilles tendonitis is a common overuse injury and is common, especially in runners. The condition is identified by pain and inflammation in the Achilles tendon, which connects the calf muscles to the heel bone.

Causes:

- Overuse: Repetive stress on the tendon by increasing running intensitiy or sudden changes in activity levels

- Tight calf muscles: If the calf muscles are tight, they can put extra strain on the Achilles tendon.

- Inappropriate footwear: Wearing shoes that do not provide adequate support or cushioning can also increase the risk.

- Poor biomechanics: Abnormal foot and leg movement while walking or running can cause strain on the tendon.

Symptoms of Achilles tendonitis & how to diagnose it

If left untreated, it can lead to the injury getting worse, such as a ruptured tendon. To prevent this, it's important to know the symptoms early on. Some common symptoms include:

- Pain, swelling, and stiffness along the Achilles tendon, especially in the morning or after periods of rest

- Increased pain during your runs or activity, especially when pushing off or starting a movement

- Tenderness when pressing just above the heel

- Limited range of motion in the ankle

To diagnose the condition, a physiotherapist will take a medical history and do a physical assessment, including assessing the range of motion in the ankle and foot. They may also refer for an MRI to determine the extent of the inflammation or tissue damage if the pain isn't getting better.

Strategies to Prevent Achilles Tendonitis

Achilles tendonitis is one of the most common sports-related injuries, affecting not only athletes but also individuals leading an active lifestyle. Fortunately, it is preventable through various approaches such as physiotherapy, pilates exercises, and a comprehensive strength and conditioning programme. Recent research has shown that these methods improve the function of the Achilles tendon and decrease the risk of injury.

Here are a few more details on how to prevent Achilles tendonitis:

- Physiotherapy rehab exercises, including specific stretches and eccentric loading exercises to help strengthen the tendon and surrounding muscles, promoting optimal biomechanics.

- Pilates exercises, such as heel raises, calf stretches (or Tendon Stretch on the refomer) can improve posture, balance, and flexibility, which are important in reducing the strain on the Achilles tendon.

- A comprehensive strength and conditioning programme, which includes exercises that target the leg muscles, increases strength, and endurance, which leads to better performance and reduces the risk of injury.

- Proper warm-up and cool-down, which involve dynamic stretching and mobility exercises to prevent sudden stress on the tendon, reducing the chances of injury.

- Wearing appropriate footwear, to support the ankle and reduce stress on the tendon during your runs or physical activity, is needed in preventing Achilles tendonitis.

Physiotherapy, acupuncture & anti-inflammotries

According to recent research, acupuncture can be effective in reducing pain and inflammation associated with Achilles tendonitis (Zhang et al., 2018). It can be used in conjunction with other physiotherapy modalities to promote healing and recovery.

However, it is recommended to limit the use of anti-inflammatory medications (neurofen/ibuprofen) as they can impair the natural healing process of the tendon (Maffulli et al., 2019).

By combining physiotherapy techniques including acupuncture with a tailored treatment plan, individuals can improve their outcomes in managing pain and inflammation.

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Self-Management Strategies

To improve mobility and flexibility in the affected tendon, several self-management strategies can be incorporated. Isometric exercises are particularly beneficial for strengthening the tendon and reducing the risk of further injury. Recent research has shown that isometric exercises can improve muscle strength by 10-15% in as little as two weeks.

Here are two strengthening exercises for Achilles tendonitis:

1. Eccentric heel drop exercise:

Stand on the edge of a step with your heels hanging off the edge. Lift yourself up on your toes then slowly lower down so that your heels drop below the level of the step. Hold for a few seconds, then lift yourself back up. Repeat 10-15 times.

2. Resistance Band Flexion:

Sit on the floor with your legs straightened in front of you. Wrap a resistance band around the ball of your foot and hold the ends in your hand. Flex your ankle so that your toes move towards you, then slowly release the tension. Repeat 10-15 times.

Here are two stretching exercises for Achilles tendonitis:

1. Standing calf stretch:

Stand in front of a wall, placing your hands on the wall at shoulder height. Step back with one foot and press the heel down towards the floor. Hold for 30 seconds, then switch to the other foot.

2. Seated butterfly stretch:

Sit on the floor with your legs straight in front of you. Bend your knees and bring the soles of your feet together. Hold your ankles and gently pull your heels towards your body. Hold for 30 seconds.

A study by Järvinen et al. (2017) found that stretching exercises combined with eccentric exercises were effective in reducing pain and improving function in individuals with Achilles tendonitis.

Physio-led Pilates for rehab

Research has shown that Pilates exercises can effectively strengthen tendons. A study published in the Journal of Bodywork and Movement Therapies found that Pilates can help rehab patients with Achilles tendonitis by increasing strength and endurance in the affected tendon. Additionally, reformer Pilates, which uses spring resistance, can provide heavy tension to further strengthen tendons. According to a study in the Journal of Sports Science and Medicine, the use of the reformer in Pilates training leads to an increase in ankle and knee strength, indicating the potential to improve tendon health. Overall, incorporating Pilates into any fitness routine not only improves muscle strength but could also promote tendon health and injury prevention.

What is Pilates

Conclusion

Achilles tendonitis is a common injury among runners, which can severely impact your mobility and run performance. This condition occurs when the Achilles tendon becomes inflamed due to repetitive stress or tightness.

Preventive strategies such as wearing proper fitting shoes, regular stretching and strengthening exercises, and avoiding overuse can help reduce the risk of it developing.

If you do experience this injury, physiotherapy can help to treat the pain and inflammation. Pilates can also be an effective rehab strategy to improve flexibility and strengthen the affected tendon.

Don't let this common injury hinder your goals, take preventative measures, and

Book a physiotherapy appointment with me today to get back to running better than ever before and achieving those running goals.

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Take Control of Your Injury: All You Need to Know About Achilles Tendonitis