What is the cause of Achilles pain?
The most common cause of Achilles pain (tendinopathy) seen in the clinic amongst patients of all ages and abilities are common overuse injuries. Generally, these tendon injuries occur when load the handling capacity has been exceeded. Factors influencing load may include changes in volume, intensity, type of exercise, change of surface, footwear and uphill running. However, systemic diseases can also affect the tendon quality (i.e.) diabetes. When the load capacity has been exceeded, we see biochemical changes that occur throughout the tendon. This can increase the sensitivity of the tendon and cause pain with activity.
During the early stages of this injury, morning pain and stiffness may be present. However, pain and stiffness may diminish as the tendon warms up, this is known as the warm-up phenomenon. As your tendon pain worsens, pain can persist throughout exercise.
Common signs and symptoms
- Pain localised to a specific area of the tendon
- Reduced strength and function
- Swelling and or palpable tendon thickening
These injuries can occur at the tendon’s insertion (where the tendon inserts into the heel bone) or through the mid-portion of the tendon. This is an important point of differentiation as they will require different management. Your physiotherapist will identify the location of your tendinopathy and tailor your rehabilitation program around this.
The irritability of the tendon is another important diagnostic piece of information. This will determine the amount of loading you can place on the tendon. Initially, you may be required to reduce loads to control symptoms and avoid further re-aggravation. Once your symptoms are controlled, loads will be increased to improve the load capacity of the tendon.
How can a physio help with your Achilles pain?
A physiotherapist will take you through a detailed assessment to ensure you obtain the correct diagnosis. Your physiotherapist will then provide you with an evidence based treatment program to help keep you moving in this time. Tendon rehabilitation can be lengthy, so it is important that you are guided throughout the stages.
Aside from exercise prescription, addressing contributing factors such as running technique and selecting appropriate footwear are important considerations. If your running technique requires further analysis, running assessments are available at Mallee Physio.
Do not let your Achilles pain slow you down anymore! Speak with one of our physiotherapists today about your tendon pain.
Written by;
Ebony Gerrish
B. App Sci & M. Physiotherapy
APAM
