What is a Tendinopathy?
Achilles pain can be extremely disruptive to your exercise endeavours and if not managed appropriately may continue to worsen. The good news is that there are treatment options available!
A tendinopathy is an overload of a tissue in the body called a tendon. Tendon attaches muscle to bone and allows movement to occur at our joints. Basically they are pretty critical to allowing us to function. If a tendon becomes overloaded (force/load applied is greater than recovery) the tendon can become injured. Tendinopathy’s make the tendon become disorganised and alters the normal structure. In an Achilles tendinopathy the location of the injury can occur at the insertion onto the heel bone (insertional tendinopathy) or mid-way up the Achilles (mid portion Achilles tendinopathy). The management of these 2 types of tendon injuries is actually a bit different.
How do I know if I have a Tendinopathy?
The only true way to achieve an accurate diagnosis is to consult a qualified physiotherapist or speak to your GP and arrange an ultrasound. Either way you will likely need a physiotherapist to help you overcome your injury.
So I have a Tendinopathy what should I do about it?
1. Rest?
No! Complete rest will not make your injury heal or repair. In fact to get a tendon better we must overload it. I know this sounds crazy but bear with me! Overload caused the injury in the first place however this overload was an incorrect type of loading, that is you did too much, your activity levels were greater than your recovery capacity, you have poor biomechanics or you are not wearing the correct footwear. Whatever the incorrect loading mechanism we can address this and apply the correct loading technique to initiate repair.
2. Exercise?
Yes, exercise is crucial to improving tendon health. A physiotherapist can prescribe the exact exercises you need to be doing. They will also advise on whether it is safe to continue your current exercise regime. We always aim to keep you doing the activities you love but we may need to help you modify these in some way for the time being.
3. Ignore it?
Absolutely not! The earlier we can treat these tendon issues usually the better outcome. When your tendon injury is in the early stages we call it a reactive tendinopathy and we are usually able to better treat the tendon and return you to your previous activity levels. Once the tendon enters a more chronic phase it becomes much harder for us to treat. The longer it is left usually the longer the rehab time as well.
4. See a Physiotherapist ASAP?
Yes! I can’t stress it enough how important it is to see a physiotherapist early. Don’t leave pain for weeks, months or even years on end. As a general rule of thumb if you have pain for >3 days and it is not changing it’s time to get it seen to. With tendons, this rule becomes blurred as a tendon may be ok during activity but become painful with rest. The pain may subside over 1-2 days however it will flare up again the next time you do the activity. If you notice this pattern it is also time to get it seen to.
See also: Biceps Tendinopathy
How do we treat an Achilles Tendon Issue?
Treatment is prescribed on an individual basis, there is no one size fits all. The physiotherapist will assess where you are at, the stage of your condition, what your pain levels and strength is like and then prescribe a program just for you. Broadly it may include some of the following treatment methods;
- Massage
- Specific Strengthening exercises – this is the big one!
- Ultrasound (in some cases)
- Graduated return to sport program
- Footwear advice
Tendon treatment and management is an ever evolving world and something we as physiotherapists endeavour to stay up to date on to provide our patients with the best management options. If you think you have an Achilles tendon issue give our friendly receptionists a call today on 9672 6752 (Kellyville) or 9871 2022 (Carlingford) to make an appointment.
