Everybody knows somebody who has had a problem with their Achilles Tendon. This structure is one of the most injured in runners and this injury is seen very often in the more recreational athlete.
It is important to understand that there are 2 major types of Achilles Tendinopathy.
- Mid-Portion
- This is the more common form.
- This affects the tendon about 2.5-3cm above the insertion on the heel.
- Generally caused by a sudden increase/change in load on the tendon.
- Insertional:
- This is less common but can be more painful.
- This is felt on the back of the heel bone itself, where the Achilles attaches.
- Generally caused by a compression (squashing) of the tendon against the heel bone as the foot is brought back towards the shin (dorsiflexion)
Insertional Tendinopathy is much harder to “cure” and I would strongly encourage you seek professional advice if you have this problem.
In a nutshell, management of Achilles Tendinopathy is about two things. The first is pain management the second is load management. It is important to understand that, as a rule, the Achilles Tendon only begins to hurt when the demands placed on it are greater than its capacity to perform said demands. This is why the Achilles Tendon doesn’t hurt when you don’t do anything.
My tips on managing Achilles Tendinopathy are:
Don’t Rest
Yes, you heard me correctly. Rest is the worst thing for any tendon problem. If you don’t load a tendon its capacity will diminish making it easier to aggravate when you need to use it. Rather than resting, you should look to modify your activity. I am a big fan of simple strength work in the early stages of Achilles Tendinopathy to build capacity. Isometric calf raises are a fantastic way of building strength and reducing pain in a symptomatic Achilles Tendon. Any quality healthcare professional will help you devise a suitable program.
Footwear/Heel Lift
Change to a shoe that has a higher stack/drop or place a heel lift inside your shoes. The greater the fall/drop from the back of the shoe to the front, the less eccentric load (lengthening load) is placed on the Achilles Tendon. Reducing this load on the tendon will reduce pain levels.
Training Environment
Get off hard ground and playing surfaces. This aggravates Achilles problems.
Running Technique/Training Intensity
If you are a forefoot/midfoot striker or do a lot of high intensity work outs, it may be worth looking to change to a heel strike pattern, go for longer runs or move to low intensity workouts to reduce the load on the Achilles Tendon until you build capacity.
Seek Professional Help
If managed early, Achilles Tendinopathy can be resolved reasonably quickly. If left, however, it can become a chronic problem which may take months to resolve. A quality healthcare professional will guide you through the rehab process and get you back doing what you love, fast!
