Whether you’re a runner or a walker, male or female, pain in the Achilles tendon is a common problem. The achilles tendon has to tolerate the highest loads in the body – up to 10 times your body weight during running, jumping, hopping and walking.
If you’re suffering with a problem with your Achilles tendon then it’s likely to be tender to touch and may feel stiff, particularly in the morning.
What is an Achilles tendinopathy?
Your Achilles tendons are the biggest, strongest tendons in your body. The achilles is the tendon formed as the gastrocnemius and soleus – the calf muscles – join to insert on to the heel bone helping you to lift your heel and propel forward when walking or running.
Your Achilles tendons adapts rapidly to cope with the demands of your activities. However, pain can develop if you exceed its capacity to adapt and an imbalance develops between the ‘wear and repair’ processes in the tendon. We call this process tendinopathy.
Classic features of achilles tendinopathy are the gradual onset of morning stiffness which may resolve within 5-10 minutes, and stiffness when walking after sitting for long periods. The morning stiffness is often worse on days after a run or exercise. The pain/stiffness will typically “warm-up” during the first 5-10 minutes of exercise. This feature often stops people seeking help as they can initially run through the pain. But the earlier you seek help, the more likely you will be able to get away with adjusting your load rather than stopping running altogether.
What are the risk factors of developing Achilles tendinopathy?
Changes in types of activity or sudden increases in exercise are often the cause of developing tendinopathy however, there are some other risk factors linked to this issue such as your age, your body weight, being diabetic, tightness/weakness in the calves or faulty foot biomechanics causing increased pressure on the Achilles tendon.
Determining the specific cause, and then correcting it, is essential in managing achilles pain
What are the best exercises for the Achilles tendon?
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.
An eccentric (muscle lengthening) exercise program is viewed as the gold standard conservative treatment of this condition. The program is designed to gradually increase the stress going through the tendon in a controlled manner. The eccentric exercises can take several months to significantly improve strength and the majority of patients will make a full return to activities within this time. The program itself is a progression through controlled heel raises starting with both legs and progressing as pain allows. As with most rehabilitation there is no quick fix for tendon issues however this is best practice to prevent recurrence and future proof your achilles to cope with the demands of exercise.