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Achilles Heel

What is it with the people of Reading? Since moving here in February I have come across so many people with Achilles problems, is there something in the water?

Achilles tendonopathy, formally known as Achilles tendonitis is a problem at the back of your lower leg, between your heel and your calf muscle. It’s a complicated issue but I will try to give an explanation of the condition, some symptoms and treatment ideas.

There are two types of Achilles tendonopathy; midportion Achilles tendonopathy where the problem is at the junction of the muscle and tendon, and Insertional Achilles tendonopathy where the problem is at the junction between the heel bone (calcaneus) and Achilles tendon. I will focus on midportion Achilles tendonopathy.

Why might I get an Achilles tendonopathy?

  • Years of running

  • An increase of activity

  • Decrease in rest between activities

  • Running surface change

  • Footwear change

  • Poor flexibility

  • Poor foot biomechanics

  • Weak calf muscles

  • Poor footwear

  • Genetic predisposition

Symptoms include:

  • Gradual onset of pain

  • Pain on squeezing

  • Pain walking up or down the stairs

  • Pain or inability to go up on to tiptoes

  • Pain with squatting

  • Pain with running/walking

  • Calf tightness, particularly first thing in the morning

How should I treat it?

Self management:

  • Relative rest

  • Ice

  • Reduce the stress on the tendon by using orthotics such as a heel lift

  • Avoid walking in bear feet

  • Anti inflamatories

See a physio who can teach/perform

  • Isometric calf stretches

  • Eccentric loading exercises

  • Massage

  • Kinesiology tape to off load the tendon ( should be applied by a qualified practitioner)

  • Ultra sound

  • Acupuncture

  • Strength retraining programme

  • proprioception

Achilles tendonopathies can take months to improve. Don’t give up but equally don’t go back to exercise too soon. The most common problem with Achilles tendonopathy is people returning to activity too soon which creates flare ups of pain and takes you back to square one.

Be patient, be compliant with your treatment programme and make changes to your training programme and you will defeat it before it defeats you!!


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