If you have pain in your Achilles tendon (at the back of your ankle), a stiff ankle in the morning and are involved in sport that has repetitive activity such as running you may have Achilles Tendinopathy.

What is Achilles tendinopathy?

Achilles tendinopathy is an overuse condition of the tendon that commonly occurs in runners, walkers and those that spend a lot of time standing. The Achilles tendon is the tendon that connects your calf muscle to your foot. A tendinopathy is a broad term that can refer to any injury to a tendon. The term tendonitis is no longer used to describe overuse tendon injuries as more recent evidence has shown that there is little or no inflammatory reaction in the tendon.

Why does it happen?

Achilles tendinopathy occurs with excessive repetitive overload to the Achilles tendon which results in structural changes to the tendon. Some predisposing factors to Achilles tendinopathy include abnormal biomechanics of the lower limb, poor calf muscle strength, poor muscle flexibility, sports involving running and poor foot posture.

Changes in training load, surfaces and footwear can also increase the risk of a person developing Achilles tendinopathy.

What will a physiotherapist do?

The physiotherapist will thoroughly assess the injured tendon and assess the mechanics to determine what factors may be contributing to the condition. Treatment may involve modified rest, ice, massage, dry needling, taping and stretches of the affected area. A specific strengthening program will also be commenced.

The physiotherapist may also treat other areas to help correct optimal biomechanical alignment and decrease the stress through the tendon. This may include massage, joint mobilisation, supportive taping and development of an exercise program to help stretch and strengthen certain areas. If the physiotherapist believes poor foot posture is a factor they may suggest orthotics or refer you to a podiatrist.

What about sport?

A graduated return to sport is necessary for Achilles tendinopathy which may take from weeks to months depending on the stage of your condition. Complete rest is rarely indicated and will not assist in the recovery of your condition. The physiotherapist will help design a modified training program for you to complete that will optimise the healing of the tendon.

Outcome

Achilles tendinopathy can take weeks to several months to respond to a proper treatment and management plan. Achilles tendinopathy may persist for longer if aggravating activity is continued and treatment not sought.