Stronger, More Flexible, Pain-Free Readers

…tips and exercises from our award winning chartered physiotherapist

Natalie MarchMy name is Natalie March from Physio-logical, a chartered physiotherapist in Stansted Park and Rowlands Castle.

The Achilles tendon is the largest and strongest tendon in the human body!  It attaches your calf muscles to the heel bone.

Tendinopathy is a term describing pain, swelling, and impaired function of a tendon. If the load we put on a tendon exceeds its threshold and we continue to do this regularly then the amount of tissue breakdown starts to exceed the growth of new tissue. The structure of the tendon then starts to change and as a result the tolerance of the tendon drops, becoming less efficient at dealing with load or normal activities.

Signs and Symptoms:

  • Normally worse first thing in the morning and after sitting for long periods of time
  • Running or jumping sports
  • Painful if you squeeze it or stretch it
  • Can worsens with activity
  • Swelling or thickening

Achilles

Risk factors
Risk for Achilles pain is multifactorial and related to tendon overloading.

  • Starting a new exercise
  • Using hard or sloping surfaces
  • Previous injuries
  • Wearing inappropriate footwear
  • Increased training
  • Diabetes
  • Inflammatory disorders
  • Biomechanical - such as leg length difference
  • Some medications such as corticosteroids and statins

Treatment
Most people with Achilles tendinopathy improve with conservative treatment. Recovery time is variable and is likely to be influenced by the severity of the injury.

  • Active Rest - reducing load from aggravating activities
  • Ice - apply for up to 20 minutes, as needed throughout the day (protect your skin with a damp towel)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief, such as ibuprofen or naproxen.
  • Low-impact activities, such as swimming.
  • Specific exercises to strengthen your calf muscles.
  • Taping

Physiotherapy will incorporate hands on treatment which may include massage, Kinesiology taping to offload the tendon and eccentric loading of the calf muscle and Achilles’ tendon. This is where the muscle will be working whilst being put on a stretch.

Preventative strategy
Once the pain has settled it is time to improve the load capacity and tissue tolerance of the muscle and tendon, to reduce to risk of re-injury. The calf complex is composed of 2 main muscles – gastrocnemius and soleus - both need to be strengthened. The simplest way of achieving this is by doing calf raises on the edge of a step. Normally you should be able to manage 10-15 single leg calf raises with minimal increase in your pain before you progress to this level.

Exercises for Achilles Tendinopathy
Please be aware of your body and take advice from your GP before exercising or send an email to (enquiries@physio-logical.net) for advice and guidance.

Eccentric Calf RaisesEccentric Calf Raises:

  • Standing balance yourself on both feet (you can use a chair for stability)
  • Rise up on your toes, slowly lower with both legs, when there is no pain progress onto 1 leg
  • Rise up on your toes, slowly lower on the injured leg with your leg straight, then repeat with your leg bent (100% bodyweight is on the injured leg).
  • Repeat 15 times do 3 sets of 15, 2 times a day, 7 days a week for 12 weeks
  • Gradually add load with some weight in a backpack

Single Leg BalanceSingle Leg Balance

  • Stand without any support and attempt to balance on your injured leg.
  • Begin with your eyes open and then try to perform the exercise with your eyes closed.
  • Hold the single leg position for 30 seconds.
  • Repeat 3 times, 2 times a day

For more tips and guidance please visit www.physio-logical.net

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