As Melbourne returns to sports and their active lifestyles, more and more people have been coming into TFC Podiatry complaining of pain at the back of their Achilles tendon. A sudden increase in exercise can be a big risk factor towards injuries like these. Today I will run through what types of Achilles pain there can be and what treatment generally consists of.
What is Achilles tendon pain?
Achilles injuries tend to be caused by overuse of the Achilles tendon, resulting in inflammation and damage to the area. This is particularly prevalent in athletes who play sports that involves high levels of running or jumping. When running, the Achilles tendon takes 6-12 times the load when compared to walking. If left untreated the chances of rupturing your Achilles tendon can significantly increase.
Overuse is the main cause of Achilles tendon injuries. Increases in load can be due to the following:
- Sudden increase in training/activity levels, particularly in activities that involve running and jumping
- Wearing unsupportive footwear or no footwear for prolonged periods of time
- Occupations where you’re required to stand on your feet for prolonged periods of time, such as nursing
- Recent weight gain
- Inadequate rest between training sessions
Other risk factors for developing Achilles tendon pain include:
- Having a pronated foot posture or a rigid high arch
- Tight posterior chains (calves and hamstrings)
- Ankle joint and big toe joint restriction
- Aged over 30 years old
- Menopause can reduce tendon resilience
- Certain medicines such as steroids
- Stress and reduced sleep
- Medical conditions such as diabetes and rheumatoid arthritis
Types of Achilles tendon pain
- Insertional Achilles tendinopathy. Pain at the insertion of the Achilles tendon closer towards the heel caused by excessive compression load on the tendon
- Midportion Achilles tendinopathy. Pain higher up on the Achilles tendon caused by overuse of the calf complex.
- Retrocalcaneal bursitis. Inflammation to the bursa between the heel and Achilles tendon which causes pain closer towards the heel. This is often accompanied by a Haglund’s deformity, which is a bony enlargement of the back of the heel.
- Os Trigonum. A small extra bony growth just behind the ankle joint that can cause ankle joint restriction and sometimes pain at the back of the ankle.
Treatment
At TFC Podiatry we offer a wide range of treatment modalities. But first we find out the root cause of the problem.
In most cases treatment often follows a similar pattern for most soft tissue injuries. First, a reduction in the load of the tendon is recommended via a reduction in activity levels, footwear modifications and addressing loads in the foot and ankle with strapping, padding and orthotic therapy. Pain management exercises are also often prescribed to help alleviate symptoms.
Once pain levels have settled down, load can start to gradually be introduced through progressive tendon loading exercises.
When you have returned strength to above 80% activity-specific exercises can be prescribed to preparation for return to sport/physical activity.
We also offer soft tissue therapy to assist in tissue healing. Shockwave therapy and Dry needling can assist in speeding up the healing process by promoting vascularisation and breaking down chronic inflammation in damaged tissue.
If you are experiencing Achilles tendon pain and would like to get it looked at feel free to book an appointment with one of our experienced Podiatrists working out at either Point Cook or Yarraville.
