• My Family Podiatry

Achilles Tendinopathy

Updated: Dec 9, 2021

Achilles’ tendon injuries can be devastating, especially leading into the festive season or while starting your New Year Resolutions. An injury to the Achilles’ tendon could prevent you participating in your favourite summer activities, or even keep you off your feet entirely.

The Achilles’ tendon is the thickest tendon in the human body and an incredibly strong structure. Connecting the calf muscle to the heel, forces many times your body weight are applied to this tendon throughout walking, running and exercise. Despite its strength and ability to take load, Achilles’ tendon injuries are a common issue we see at My Family Podiatry.

How Do I Know If I Injured My Achilles’ Tendon?

There are grades of Achilles’ tendon injuries, ranging from low levels of damage, all the way through to complete rupture of the tendon. Most people presenting to the clinic will be experiencing pain and stiffness in the back of the ankle, particularly after periods of rest and pain which increases with exercise, becoming quite severe the day after a large amount of activity. The most common precursor to Achilles injuries is a sudden increase in activity. This can include a return to sport after off-season, a sudden increase in physical demands at work (longer periods of time standing or more walking) or taking up a new activity such as long walks or jogging without any prior conditioning.

How Are Achilles Injuries Treated?

Despite it’s size, the Achilles’ tendon is poorly vascularised meaning the blood supply is not as high as other tendons. This can lead to longer healing times for Achilles’ tendon injuries compared to other soft tissue injuries.

Rest: Ceasing the aggravating activity is important for recovery of Achilles’ tendon injuries. If running is leading to severe pain, other low impact forms of exercise need to be considered such as elliptical machines or cycling.

Eccentric Loading Exercises: The Achilles’ tendon is primarily made up of collagen fibres which are disrupted during tendinitis. Eccentric loading exercises provide the body with information on how the fibres should be arranged by placing the “correct forces” through the tendon. Depending on the location of your Achilles’ tendon injury, these exercises will typically involve a calf raise with an isometric hold at the top before a slow lowering back to the ground (or off a step). Eccentric loading describes the lengthening of the muscle whilst contracted, a movement which places forces through the tendon to encourage healing.

Avoid Stretching: At My Family Podiatry, we discourage stretching for Achilles’ tendon injuries. Though it is important to reduce tension in the calf muscle, we prefer to do this through massage techniques rather than placing increased load on the tendon by stretching. This can involve using a foam roller or rolling pin to work on the calf muscle or going for a massage on the calves. Dry needling can also be used on the calves and lower leg to reduce tension in these muscles.

Orthotics: The position and movement of the foot through standing, walking and running can dramatically change the loads being placed on the Achilles’ tendon. Orthotics can be used to change these forces, reducing the load placed on the tendon, reducing pain and allowing the tendon to heal.

Tips To Avoid Achilles’ Tendinitis

Increase Exercise Gradually: Rapid increases in exercise is one of the main contributors to Achilles’ tendinopathy. Especially with the new year approaching, ensure your return to running is gradual, not from 0km/week to 50km/week immediately. Tendons need time to adjust to the loads being placed on them, so if your goal is to run 5km/day, start with 1km, build this over a fortnight to 2km and so on until you reach your goal. This ensures the increased load each week is not excessive and the body is capable of absorbing the force without issues arising.

Stretch And Massage Calves: Regular stretching or massage of the calves will ensure these are not becoming too tight, restricting ankle range and placing increased load on the Achilles’ tendon. We recommend holding your stretches for 45 seconds to give the muscles time to relax and stretch.

Change Footwear Gradually: Moving from high heels all week to barefoot and thongs all weekend places very different loads into the Achilles’ tendon. If you are in a role which requires wearing high heels, ensure you are stretching and massaging your calves regularly to ensure these do not become problematic.

At My Family Podiatry, we regularly treat Achilles’ tendon injuries. If you have been struggling with a problematic Achilles or are suffering while trying to return to exercise, give the team a call on 07 3088 6116 or contact us through the button below.

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