Achilles Tendinopathy - Will Stretching Help?
(Video Transcript):
If you have Achilles tendon pain, then maybe this is holding you back from doing the activities you love, like walking or running.
Especially first thing in the morning when you have to hobble your way out of bed.
When you have an Achilles Tendinopathy, often your calf and Achilles can feel really tight and stiff, and it feels like you should stretch it out.
But in fact, stretching can often make the pain and stiffness worse, because what you are doing is just upsetting an already angry tendon by stretching it apart.
A better approach is to work out much load or exercise your tendon can tolerate, and then progressively strengthen the tendon over time within these limits.
Or if your Achilles tendon or calf feels tight there might be other ways to help it feel looser, for example by using a foam roller or a spikey ball to roll out the tight spots without upsetting your angry tendon.
If you're looking for more information about Achilles Tendinopathy, check out the information below...
Causes of Achilles Tendinopathy
Achilles tendinopathy is an overuse injury that affects the Achilles tendon, the large tendon that runs down the back of the leg and connects the calf muscles to the heel bone. The Achilles tendon is used when walking, running, and jumping, and is one of the most important tendons in the body. Achilles tendinopathy is a type of overuse injury that results from repeated stress on the Achilles tendon. This stress can cause the tendon to become inflamed, weak, and damaged. Achilles tendinopathy is most common in athletes who participate in sports that involve running and jumping, such as basketball, track and field, and tennis. However, it can also occur in non-athletes who have a job or hobby that involves repetitive stress on the ankle and calf, such as running or dancing.
Achilles tendinopathy can also be caused by certain medical conditions, such as rheumatoid arthritis and diabetes. This can sometimes occur alongside these diseases because they can cause changes in the structure of the Achilles tendon, making it more susceptible to injury.
The condition is most common in middle-aged adults, and it can occur suddenly or develop slowly over time. There are two main types of Achilles tendinopathy: insertional Achilles tendinopathy, which affects the portion of the tendon where it attaches to the heel bone, and non-insertional Achilles tendinopathy, which affects the middle portion of the tendon.
Symptoms of Achilles Tendinopathy
Achilles tendinopathy is a condition that can cause pain and stiffness in the Achilles tendon, the large cord of tissue that connects the calf muscle to the heel. The Achilles tendon is used when walking, running, and jumping, so any pain in this area can make it difficult to perform these activities. Similarly to Plantar Fasciitis, Achilles tendinopathy may be caused by repetitive stress on the tendon, such as from overuse during running or other high-impact activities. It can also be caused by an injury to the tendon, such as a tear or rupture. Symptoms of Achilles tendinopathy include pain and tenderness in the back of the lower leg, stiffness and weakness in the Achilles tendon, increased tendon thickness, and creaking or cracking sounds when moving the affected leg. Morning stiffness in the Achilles tendon is also common. These symptoms can often be worse with activity, such as running or jumping, and may improve with rest.
Do I Need any Investigations for Achilles Tendinopathy?
In most cases, Achilles tendinopathy can be treated without the need for any investigations. The first line of treatment is usually physiotherapy and pain relief medication. However, if the pain does not improve after several weeks, your doctor or physiotherapist may recommend getting an MRI or ultrasound scan. These tests can help to rule out other conditions, such as a tear in the tendon or a bone spur. Investigations are usually only recommended if you have severe pain or if you are a competitive athlete who needs to return to training quickly.
Treatment For Achilles Tendinopathy
Achilles tendinopathy is a common condition that can cause pain and stiffness in the Achilles tendon, the large tendon that runs down the back of the leg. The condition is often caused by overuse or repetitive stresses on the tendon, and it can be difficult to treat. However, physiotherapy can often help to improve symptoms. Physiotherapy involves exercises that strengthen the Achilles tendon, as well as other treatments such as manual therapy, massage, taping, bracing, and load management to promote tendon healing- for example trialing a period of relative rest from the aggravating activities, followed by progressive loading as the tendon strength and function improves. In most cases, physiotherapy is successful in treating Achilles tendinopathy and helping people to regain full function of the tendon.
How Long Does Achilles Tendinopathy Last?
Although this condition can be painful and debilitating, it is often treatable and will improve within a few weeks to months of beginning treatment. However, in some cases, Achilles tendinopathy can be chronic and long-lasting. This is more likely to occur if the condition is not treated early on, or if there are underlying risk factors.
Is there a difference between Achilles Tendonitis and Achilles Tendinopathy?
Tendinoapthy and Tendonitis are somewhat different but are basically two descriptors of the same underlying condition. The key difference is that Tendonitis means "Tendon inflammation", whilst Tendinoathy means "Tendon damage without inflammation". There has been conjecture as to whether degenerative or overuse tendon conditions do have the presence of inflammation in the tendon. Regardless, the treatment and recovery timeframes of the condition do not drastically differ whether there is inflammation in the tendon or not.
Will I Need Surgery For My Achilles Tendinopathy?
Surgery for Achilles Tendinopathy is extremely uncommon and not normally warranted. In most cases, the condition can be treated effectively with physiotherapy and rest. However, if you have severe pain that does not improve with treatment, or if you are a competitive athlete who needs to return to training quickly, surgery may be recommended. The main types of surgery for Achilles tendinopathy are tendon debridement and tendon repair. Debridement is usually only recommended if there is a large amount of scar tissue in the tendon that is causing pain. Tendon repair is usually only recommended if the tendon has been completely torn (ruptured).
What Other Treatment Options Exist For Achilles Tendinopathy?
In addition to the conventional treatments for Achilles tendinopathy, such as rest, ice, and physical therapy, Extracorporeal Shock Wave Therapy (ESWT) is a newer treatment option that is showing promising results. During ESWT, high-frequency sound waves are used to generate shock waves that pass through the skin and target the affected area of the tendon. These shock waves help to promote healing by stimulating the release of growth factors and breaking down scar tissue. A course of ESWT typically consists of 3-5 sessions that are spaced a week apart. Although ESWT is a relatively new treatment, initial studies have shown it to be safe and effective for the majority of patients.
Cortisone is a type of anti-inflammatory medication that can help to reduce pain and swelling. Cortisone injections are usually only recommended if other treatments have failed to improve symptoms. The injections can be painful, and there is a risk of the medication damaging the tendon. Therefore, they are usually only given as a last resort.
Platelet-rich plasma (PRP) injections are another newer treatment option for Achilles tendinopathy. PRP is a type of blood plasma that contains a higher concentration of platelets (a type of blood cell that helps with the healing process). Platelet rich plasma (PRP) is a newer treatment that is showing promise for Achilles tendinopathy. PRP is a concentration of platelets taken from the person's own blood. The platelets are injected into the Achilles tendon, where they release growth factors that promote healing.
Will an Achilles Tendinopathy Lead to a Complete Tendon Rupture?
One of the most common tendon injuries is Achilles tendinopathy, which is a condition that results in the inflammation and degeneration of the tendon. Although tendinopathy can be painful and debilitating, it usually does not lead to a complete tendon rupture. Achilles tendon ruptures are much rarer, and they typically occur in people who have already had an injury to the tendon. Whilst is still possible for the tendon to rupture with enough force, in most cases a rupture is very unexpected, with no signs or symptoms of pain in the lead up to a rupture. Movements that are most likely to cause an Achilles Tendon Rupture are things like explosive running, jumping or bounding movements.
