It’s that time of year again when the days are getting longer and the temperature is on the rise, tempting us outdoors for some exercise. Whether you're dusting down your running shoes for the first jog of the year, or perhaps swapping the swimming pool for the tennis court, the demands placed on your body will alter with the change of activity. When this happens we are susceptible to injury as our bodies are not trained for the specific requirements of the new activity. One common problem is Achilles tendonitis.
What is Achilles tendinitis?
The Achilles tendon is at the bottom of the calf muscle, connecting it to the heel. It is the thickest tendon in the entire body and is easily identifiable as the thick rope-like structure behind the heel. The reason it is so thick is because all of our body weight is transmitted through it whilst we are walking and running. To give you an idea of the amount of stress it has to withstand, it is estimated that a force equal to 12 times the body weight is transmitted through the Achilles tendon in sprinting. Because the tendon is required to transmit such large forces, it can be prone to being overloaded leading to breakdown. Overload causes damage to some of the thin fibres within the tendon, creating inflammation and the beginning of what’s known as Achilles tendinitis. If the overload continues, the process of tendon breakdown advances and becomes a chronic tendon injury, or tendinosis. At this stage the tendon structure has been significantly altered and the process of recovery can be lengthy.
So what causes the Achilles tendon to become overloaded?
There are many ways that the Achilles tendon can be overloaded. A sudden change in activity level, a change in the type of activity you are doing, using footwear that doesn’t provide adequate support, faulty foot biomechanics such as fallen arches, or tight leg muscles can all contribute to or cause tendon breakdown. Determining the specific cause, and then correcting it, is essential in managing tendinitis.
What can I do to treat it?
Once the causative factor has been identified it needs to be corrected to prevent further tendon breakdown, then the process of healing and strengthening can begin. One common technique used to promote healing is called deep transverse friction massage, which involves rubbing across the tendon fibres to reduce the pain and stimulate tendon repair. A specific strengthening program that involves eccentric strengthening (the tendon working whilst it is lengthening) has been shown to aid tendon repair so this should be commenced as soon as possible. Other modalities such as ice, ultrasound, and acupuncture can also help to reduce the pain. Once the tendon has been strengthened and is pain-free, it is time to get out and enjoy the spring sunshine again.
If you think you may be suffering from tendinitis, please get in touch with us here at the Physiotherapy Place in Portobello, Edinburgh on 0131 669 3369.