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Writer's pictureEmma Marsh MCSP BSc (Hons) KTP

Achilles tendonitis - ouch!

The warmer weather is slowly creeping into Cumbria and we’re desperate to make the most of every minute. Rightly so!


Current restrictions mean that there’s little we can do in our spare time but get outside for our daily exercise, and as such many of us are braving the elements so we can stretch our legs.


Hopefully, spring will soon be here to stay, bringing with it increased opportunities for activity and fun. We deserve it, right?


What we don’t deserve are the injuries that come with movement. Regardless of our activity levels, we’re all at risk of muscle strain and acute injury.


Whether you’re a regular runner or someone who’s forced out into the elements to walk the dog, any one of us can contract a nasty bout of achilles tendonitis.


What is Achilles Tendonitis?


Well, to begin with, it’s very common. So, you’ll be in good company if you’re a current sufferer. Achilles tendonitis is an overuse injury that can come on suddenly and in the worst case scenario, can result in a rupture of the achilles tendon.


But never mind what achilles tendonitis is, let’s begin with where it is.





The largest tendon in the body, the achilles tendon is a tough band of fibrous connective tissues. It attaches the calf muscle to the heel bone and, if you’re a runner, is a tendon that gets a fair battering on a regular basis.



Despite this, the achilles tendon can withstand a lot of action. When we run and jump the tendon acts like a spring, maximising our performance. The stiffer the spring is, the more energy is stored which in turn makes running easier. It’s pretty miraculous!


What causes Achilles Tendonitis?


Unfortunately, achilles tendon fibres weaken and fray from repeated stress. In turn the tendon tries to heal itself which can lead to the formation of troublesome lumps or nodules.


According to the NHS, achilles tendonitis accounts for between 6-17% of all running injuries and a massive 50% of injuries in elite athletes, so it’s a common problem and one that us physiotherapists come across on a regular basis.


Achilles tendonitis can also develop in 6% of non-athletic populations, so you don’t necessarily have to be a regular runner to suffer from this condition.



Symptoms of Achilles Tendonitis


● Stiffness of the area, particularly in the morning - you may also experience discomfort when you’ve been sitting for a while or when walking down the stairs.


● Tenderness - the tendon is quite close to the surface of the skin and so it can look red and feel painful, even with the lightest touch.


● Pain during or after exercise - you might find that pain eases a few minutes into gentle activity but gets worse when you’re engaging in more strenuous exercise, with pain up to a few days later.


● If the pain you experience is severe then we advise you seek the advice of your health care provider.



Preventing Achilles Tendonitis


It might not be possible to completely avoid it but there are measures you can take to reduce your risk of injury.


Don’t rush into an intensive exercise regime - it’s tempting to throw yourself into running but you wouldn’t advise a friend or family member to start with a 15k run when they’ve never put on a pair of running shoes, would you? Follow our advice and ease yourself in; that way you’ll avoid injury and your running career will last for years, not days. Click on this link for more Fellside Physiotherapy advice on graded exercise: https://www.fellsidephysiotherapy.co.uk/post/get-smart-this-january



Avoid activities that place excessive stress on your achilles tendon - hill running can be particularly punishing on the achilles tendon so if you do it, warm up beforehand with gentle jogging. If you experience pain when exercising, stop.


Take a few minutes to stretch your achilles tendon and calf muscles, each morning and before and after exercise. This simple movement will encourage flexibility.


Here are 2 simple stretches you can incorporate into your routine:


GASTROCNEMIUS STRETCH

○ Place your hands on a wall or chair. If you’re using a wall, place your hands at eye level.

○ Step the leg you want to stretch behind you. Keep your back heel on the floor and point your toes straight ahead.

○ Bend your other knee toward the wall, keeping your back leg straight.

○ Lean toward the wall until you feel a gentle stretch in your calf. Don’t lean so far that you feel pain.

○ Hold for 30 seconds. Complete 3 reps.


HEEL DROP


*Do this stretch with the leg that is experiencing achilles tendon pain or discomfort.

○ Whilst standing on your bottom step, hold on to the railings of your staircase.

○ Put the ball of your foot on the edge of the bottom step.

○ Let your heel drop down, allowing your other foot to relax.

○ Hold for 30 seconds. Complete 3 reps.

○ If you have trouble balancing, do this exercise under supervision.


Treating Achilles Tendonitis at Home

The most effective way to quickly treat achilles tendonitis during the early stage of discomfort is with ice therapy. If you don’t have an ice pack, wrap a bag of frozen peas in a damp cloth and apply to the tendon no more than 4 times a day for up to 10 minutes at a time. Be careful when doing this; make sure you don’t get a case of ice burn!

The RICE (Rest, Ice, Compression, Elevation) protocol should also be applied. Rest the tendon, apply the ice pack, wrap the injured area with a bandage to reduce swelling and elevate your foot to avoid swelling.

Click here for more information on ice treatment for acute pain: https://www.fellsidephysiotherapy.co.uk/post/cold-as-ice


________________________


If you feel you need more intensive therapy for your inflamed achilles tendon then please get in touch and we’ll do our best to help.












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