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Run Well: Achilles Tendinopathy

Posted Aug 06 2009 10:08pm

We are excited to kick off a new series in partnership with Sports Injury Clinic.   www.sportsinjuryclinic.net

   This site has been a well used site by me over the last year as I have worked through various injuries.  It provides the right amount of detail about the injury and tips on treatment as well.   And while we hope you don' t have the need for the resources, we are pleased to offer articles in tips in the event you are dealing with a running injury.

 

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Achilles tendinopathy is a common running injury. It is sometimes known by other names such as tendinitis, however this means inflamed tendon, and recent research has shown that there is no inflammation present in most cases.

The achilles tendon is the long thick tendon at the back of the ankle. It attaches both the Gastrocnemius muscle and its smaller, deeper neighbour the Soleus muscle, to the heel bone (calcaneus). Its job is to help provide the power in the push-off phase of the gait cycle.

Achilles tendinopathy generally is an overuse injury which comes on gradually over a period of time. It can however be quite a short period, only a few days. Usually in this time, strain through the tendon will have increased rapidly, for example increased training or lots of hill running.

Achilles teninopathy can either occur in the mid-portion of the tendon, around 4-5cm above the heel, or can be insertional, meaning right at the attachment point.

Symptoms of achilles tendinopathy:

Ø     Pain in the achilles tendon

Ø     Pain when pressing on the achilles tendon

Ø     Pain may initially fade after a warm-up but will become constant as the condition progresses

Ø     The tendon often feels very stiff in the mornings or after long periods of rest

Ø     You may feel nodules (small lumps) within the tendon

Ø     The tendon may appear thicker and redder than the other one

Ø     You may feel a creaking sensation within the tendon as you move the ankle

What causes achilles tendinopathy?

The most common causes are as follows:

Ø     Limited range of motion at the ankle – caused by tight calf muscles

Ø     A sudden increase in training or difficulty such as hill running

Ø     Overpronation (where the foot rolls inwards excessively as we run)

Ø     Inadequate rest time

Ø     Weak calf muscles

Ø     New or inappropriate footwear

Ø     Constantly wearing high heels and then changing to flat shoes

Treatment

Treatment of achilles tendinopathy should be centered around correcting the causative factors:

Ø     Rest from training and any other aggravating activities

Ø     Apply cold therapy to the tendon for 10 minutes at a time, up to 5 times a day

Ø     Wear a heel pad (in both shoes to avoid back problems!) to raise the heel slightly which will temporarily take the strain off the tendon.

Ø     If you overpronate, try some arch support insoles

Ø     Gently stretch the tendon and calf muscles to gradually increase the flexibility and range of ankle motion

Ø     Once pain-free, start to strengthen the calf muscles. Research has shown that eccentric training is most beneficial

To strengthen the calf muscles eccentrically, stand on a step with the heel just off the back. Lift the unaffected leg up so you are on one leg. Slowly lower the heel down as far as you can comfortably manage, making sure you maintain control throughout. When you are at the bottom, place the other foot back on the step and use this one to lift you up to the starting position again. Repeat this 10 times to start with, and if there are no adverse effects, then gradually increase the number you do.

We always advise seeking professional treatment in order to return to fitness as soon as possible and free from pain! A professional sports injury specialist may also:

Ø     Use treatments such as ultrasound to ease pain and swelling and to promote healing

Ø     Apply sports massage techniques to the calf muscles to loosen them off and also to the tendon to increase blood flow which is associated with healing

Ø     Apply tape to the ankle to take the strain off the tendon

Ø     Advise you on a full rehabilitation program

 

For more information onachilles tendinopathy treatment and rehabilitation, including taping tachniques, exercises and a sports massage demonstration, please visit:

www.sportsinjuryclinic.net

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