Achilles tendinopathy is a painful and often debilitating condition that affects the Achilles tendon, causing swelling, stiffness, and discomfort. This common overuse injury occurs due to repeated microtraumas—tiny injuries to the tendon—that fail to heal completely. Over time, this can lead to scar tissue build up, causing pain and even thickening of the Achilles tendon.
The Achilles tendon consists of tightly aligned collagen fibres designed for strength and stiffness, ensuring proper function. However, after repeated microtrauma, these fibres can become disorganised, creating space for unwanted cell growth and blood vessels, which may result in a painful lump or thickening in the tendon.
Achilles tendinopathy can affect individuals of all ages, and several factors may contribute to its onset, such as:
- Sports training involving running and jumping
- Incorrect foot position, like having a high or low arch
- Ill-fitting shoes, particularly those that strain the tendon
- Weak gluteal muscles, which can alter walking mechanics, placing excess stretch on the tendon
This combination of factors can make the tendon more vulnerable to microtrauma.
How to Treat Achilles Tendinopathy
Orthotics:
A thorough assessment by your physiotherapist can identify whether foot position plays a role in your condition. If necessary, orthotics or insoles may be recommended to correct your foot position, particularly for those with high (supinated) or low (over-pronated) arches.
Manual Therapy:
At Bradley Physio, we provide hands-on treatments aimed at managing pain, reducing swelling, and addressing tendon thickening. Techniques such as Deep Friction Massage, Interferential Therapy, Ultrasound Therapy, and Shockwave Therapy (in certain cases) are employed to break down scar tissue and encourage realignment of damaged collagen fibers.
Exercise:
Exercise is crucial for effective treatment and rehabilitation. Research shows that structured loading exercises promote healthy collagen production, replacing damaged tissue and improving tendon health. By managing the load placed on the tendon, we can encourage healing and recovery.
In addition, strengthening the gluteal muscles is key, as weak glutes can affect lower limb alignment and biomechanics, contributing to Achilles tendon issues.
EFFECTIVE EXERCISES FOR ACHILLES TENDONOPATHY
1. Stretches
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- Towel Stretch
Sit with a towel or resistance band looped around your foot.
Gently pull your toes toward you to stretch the calf.
Hold for 20-30 seconds. - Standing Calf Stretch
Step forward with one foot and bend your knee,keeping the back heel flat on the floor.
Feel the stretch in your rear calf.
Hold for 20-30 seconds. - Standing Soleus Stretch
- Stand facing a wall with one foot slightly behind the other.
- Push your back heel into the floor while bending your knee.
- Hold for 20-30 seconds.
- Towel Stretch
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2.Eccentric Loading Exercises
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- Eccentric Calf Raise
Stand on a step with your heels hanging off the edge.
Push up onto your toes, then slowly lower your heels down.
Repeat 10-12 times. - Step Down
Slowly lower the heel toward the floor by bending the knee.
Push back up once you feel the stretch.
Repeat 10-12 times.
- Eccentric Calf Raise
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3.Gluteal Strengthening
- Step Up
Stand at the bottom of a step and place one foot on the step.
Drive through your heel to step up, straightening your hip and knee.
Return to the starting position and repeat 10-12 times on each leg. - Heel-Elevated Squat
Stand with feet hip-width apart, heels elevated on a towel.
Squat down by sitting back, then push back up through your heels.
Complete 10-12 reps. - Gluteal Bridge
Lie on your back with knees bent.
Squeeze your glutes and lift your hips off the floor, holding for 3-4 seconds.
Slowly lower back down. Repeat 10-12 times.
For a challenge, lift one leg while maintaining a straight pelvis.
