What do Achilles Tendons do?
Tendons have two primary roles. One is to allow for the transfer of energy from muscle to bone whilst the other is storing and releasing energy like a spring.
The Achilles tendon is unique in that the failure point can be in the middle or at the base of the Achilles near the heel which is why an assessment is vital at the beginning to prevent the likelihood of chronic damage or rupture.
Achilles Tendonopathy should not be completely rested!
Despite what you may have thought, completely resting an Achilles Tendonopathy injury does a lot more worse than good. Because your tendon is responsible for the transferring and releasing of energy, if the cells in your tendon have a window of time where they cease to function, two problems commonly occur.
- Injuries become more prevalent in other areas of your body such as your back, hips and knees due to compensatory patterns developed from guarding a painful ankle.
- When returning back to training an underactive tendon due to rest will be unable to transfer forces appropriately commonly resulting in re-injury, further weakness and quite often chronic problems that come and go as activities start and stop.
Can you train with an Achilles Tendonopthy?
YES, you can still continue training. However, your program has to be modified by a sports podiatrist who commonly works with runners and athletes.
For people who push through their tendon pain unguided, the risk of rapid cell swelling in the tendon is inevitable which changes how the cells line up and transfer energy through the tendon. Therefore the risk of Achilles tendon tearing, rupturing or a chronically thickened tendon is commonly prevalent.
What is the recovery and treatment process at Melbourne Sports Podiatry?
- We have to confirm it is the Achilles tendon and not the neighbouring muscle, bursae or bone contributing to your pain.
- We begin you on an isolated strength program and calf muscle release treatment immediately. No matter if you are an elite level athlete or someone who is overweight and inactive we MUST keep the cells in the tendon active, calves relaxed and pain receptors dampened.
- As quick as your body allows, start to challenge the tendon with modified exercises that resemble energy transfer and energy release to return you back to running and change of direction training. This can be done in a matter of days, weeks or months depending on how quickly you adapt to your program and start treatment.
- The utilisation of different footwear, custom orthotics or heel lifts are used for some patients who are in severe pain or unable to slow down training due to an event/game/goal. The modification places the tendon into a shortened and optimised position to release force efficiently so that you can continue to perform day to day activities with minimal aggravation or pain.
I have previously tried all the above strategies but for some reason, my pain is always coming back?
Tendons are a nightmare to treat if you don’t have a very specific plan and strategy. As sports podiatrists with over a decade of seeing foot and ankle injuries, we understand the Achilles tendon, as well as plantar fascia, are the two most poorly rehabilitated foot and ankle structures because these cells when injured don’t recover like muscle (skeletal) cells or bone cells.
Hence quite often we see patients being provided with great exercises, but without understanding the clear DO’s and DON'Ts in the recovery period so that the fibres in the tendon can adapt and develop long term resilience.
What are the symptoms of Achilles tendon injuries?
The symptoms of Achilles tendinopathy include:
- Pain and stiffness in the Achilles tendon in the mornings and beginning of training
- Early staged Achilles Tendonopathies will warm up and settle the more you encourage blood flow to the area (this masks the damage which is occurring)
- In a later staged Achilles Tendonopathy pain will return to the tendon later during training or the following morning.
- The tendon is tender to touch and sometimes swollen and red.
- You may feel weak or unresponsive when you have pushed through the pain for too long.
- If you have partially torn your Achilles, you will be hesitant to point your toe to the sky or placing pressure through your feet when walking.
- If you have completely torn or ruptured your Achilles, it will feel like you’ve been kicked or shot in the back of your ankle. You will require immediate imaging and splinting for a tear or rupture. Sometimes surgery is also required for complete rupture.
- If you have pain swimming, cycling or at the top of a vertical jump then this type of Achilles tendon injury is treated differently.
If you have one or a few of the symptoms listed, then book an appointment online with Melbourne Sports Podiatry so that we can make sure to correctly treat your Achilles tendon injury.