Updated: Jul 22, 2019
The Achilles tendon is the largest tendon in the body. The two calf muscles known as gastrocnemius and soleus attach to the back of the leg and form the achilles tendon that inserts at the back of the heel bone (calcaneus). There is also a small muscle, plantaris that also forms this complex.
Tendons are quite avascular structures (reduced blood supply) and for this reason they can contract and bear load for extended periods of time. The Achilles tendon can bear load between 3 to 12 times our body weight depending on the activity we are doing.
Achilles tendinitis refers to inflammation of the tendon, but recent research has found that in most cases the tendon isn’t inflamed. The tendon swells and starts to get micro-tears which can lead to a tendinosis or degeneration of the tendon. Tendinopathy is an umbrella term term used for painful/ dysfunctional tendons. It is important to get assessed by a trained professional as there are other structures in the area that can be affected such as the para-tenon, fat pad and plantaris muscle.
The symptoms of Achilles tendinopathy are typically pain at the back of the ankle which can be present only with activity and then progress to be present all the time. Stiffness and swelling can also be present.
Achilles tendinopathy usually starts as an overuse injury whereby the load going through the tissue is too much and the body cannot adapt quickly enough to cope with the extra load. Extrinsic factors include changes in activity (more activity or a different activity), running/walking on a hard surface or on an incline/decline and training errors. Intrinsic factors include age, gender, muscle strength, joint stability and lower limb mechanics.
Treatment involves looking at both the intrinsic and extrinsic factors. Reducing load in the short term is the most ideal option as well as utilising manual therapy and low level laser to help reduce pain and stiffness and begin the road to tendon recovery. Orthotic therapy is useful to help improve lower limb mechanics to further reduce strain and load through the tendon. In the long term, strengthening the lower limb and improving stability will improve the tendon tolerance to load and reduce risk of re-injury.
At The Perth Foot and Ankle Clinic we have experienced clinicians and the latest evidence based treatment modalities to help you get better quickly and back to your daily activities. We offer a wide range of treatment modalities such as dry needling, myofascial release, low level laser therapy, prescription orthotic therapy, ultrasound therapy, taping and rehabilitation exercises and these are dependant on the nature and type of the complaint.
Our bodytech scanner/ treadmill can assess and provide an in-depth analysis of your stability, balance and walking style and this assists us further in creating a management plan that will be suitable for you and your injury.