Wellness Osteo

Wellness Osteo

At Wellness Osteo, we are osteopaths who focus on achieving optimal health and wellness, which means treating you and sharing our expertise with you. Read on for the ins and outs of osteopathy.

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Achilies tendinopathy

What is it

The Achilles tendon is the biggest and strongest tendon in the human body. It attaches your calf muscles to the bones in your foot. 

Achilles tendinopathy is a common overuse injury usually associated with an increase in training volume or intensity. 

A tendinopathy occurs because of a failed healing response. When we exercise, we cause repetitive micro-traumas in our muscles and tendons, or little tears. Don’t worry, this is safe and happens to us all daily, it is the repair of these tissues that give us bigger and stronger muscles. Where the problem occurs is when we don’t allow our body’s enough time to rest and recover properly, or we do a session that is too hard and our tissues can’t handle the load/force being put through them. This failed healing response leads to the degeneration of tendons, inflammation, pain and weakness where muscles meet bones, and therefore, a tendinopathy. 

Symptoms

Pain and local tenderness above the back of the heel. A stiff, dull, achy pain. This pain usually comes on gradually, most commonly after a sudden increase in training volume or intensity. So doing a harder than normal training session, or restarting physical activity after not doing much activity for a while. 

Morning heel pain is a hallmark symptom of Achilles tendinopathy. The first few steps out of bed are very hard, but once your body warms up after a bit more movement and stretching, the pain usually subsides. 

Pain also most commonly comes on at the start of physical activity, can be no pain during, and then pain several hours after doing physical activity. This pain can be relieved by heat and stretching.  

Foot range of motion will also be limited, with some crepitus on movement, as well as decreased strength in the foot. 

Causes

The biggest cause of Achilles tendinopathies are overuse or overburdening. This can occur from too much intense exercises, usually running or jumping, with the Achilles not being strong enough to handle the load being out through it. Then the tendon is not allowed enough time to recover back to its normal state leading to pain, inflammation and the degeneration of the tendon.  

Risk factors when it comes to Achilles tendinopathies include long term high heel wearers, lack of flexibility or stiff ankles, an increased foot pronation and a sudden return to physical activity after a long period of inactivity. 

Treatment/management

It is important to know that complete rest is not advised when you have a tendinopathy, but instead patients should continue their physical activity but at a decreased intensity and volume so they can train within their pain limits. 

Less strenuous exercise should be encouraged so the tendon has a chance to heal, but complete rest should be avoided as it will lead to muscle wasting and risk of re-injury after the pain has subsided is much greater. 

This should be matched with a personalised exercise rehabilitation program to strengthen the tendon and muscle while it heals. The stronger the muscle the more force can be handled by the tendon. 

Once pain is under control, a jumping and running program should be slowly and progressively introduced so the patient can return to full intensity physical activity once again. 

Manual therapy can also help by aiding in joint mobilisation, increasing ankle range of motion and keeping the calf muscle active and healthy.