The Achilles Tendon is a strong, thick tendon that stores and releases energy during dynamic functional activities such as hopping, jumping and landing.
Achilles Tendinopathy refers to a number of changes to the structure of the tendon including degeneration of the extracellular matrix, disorganization of collagen (strong build blocks of tendon) and neurovascular ingrowth.
Ultimately the tendon structure is altered causing pain and limiting function.
Achilles tendon injury is considered multifactorial, with a number of extrinsic and intrinsic factors.
Quite often, Achilles injury occurs because of a sudden change in volume or intensity of activity, which increases the load on the tendon beyond its capacity and threshold for injury.
Other factors that may predispose someone to Achilles tendon injury include calf muscle strength and endurance, previous activity levels, foot and lower leg biomechanics, age, metabolic health such as Type 2 diabetes, obesity and menopause.
There are many different causes for pain around the Achilles region, and often there can numerous injuries all presenting at once.
A podiatrist understands the anatomy, mechanism of injury and symptomatic presentation of Achilles injuries to provide a clinical diagnosis.
If we think it’s necessary, we can refer for X-ray, Ultrasound or MRI to provide further insight and accuracy to your diagnosis.
Key principles in the treatment of Achilles Tendon injuries include load management, exercise progressions and pain monitoring.
In the initial phase of injury, it is important to reduce activities that provoke pain. Adjuncts such as anti-inflammatories, wedges/inserts, dry needling, massage and strapping may be used if necessary for pain and function.
Exercise therapy is the best form of treatment, however it is essential that the dosage is effective and the exercises are progressed gradually and safely.
Pain monitoring and activity levels are important information to keep in order to constantly adjust the loads placed on your injured tendon.
Other treatments such as injections and shockwave therapy may be recommended on a case by case basis.
Overall, a tailored treatment plan and a little bit of persistence and patience is often required for effective Achilles tendon management.