7 days ago3 min read

Achilles or Heel Pain? Stop Limping, Start Winning!

Do those first steps in the morning feel like walking on glass? Is your ankle creaking and cracking after Run Geelong or a weekend of Pickleball with the Geelong Pickleball crew 🏃‍♀️🏓

You might be dealing with Achilles tendinopathy—a common issue for runners or anyone who jumps back into sport too quickly without building strength. Maybe you smashed a few games on Sunday and by Monday, you’re hobbling around like a drunk gorilla! 🦍 Learn more below -

Achilles Tendinopathy can be a real pain!...

It's a common issue for runners and anyone who does a lot of physical activity, and it can disrupt your life if not managed properly and hang around for ages! Lets change the narrative and work out what type you may have. At Move Sports Physio in Newtown - we will do a full assessment to work out where your tendon is grumpy and how to load it safely without giving you a flare-up.

The 3 Stages of Achilles Tendinopathy

Reactive: This is the initial stage where the tendon reacts to excessive stress. It becomes inflamed and painful.
Disrepair: The tendon is still painful but starts to show signs of damage. The healing process is ongoing but not yet complete.
Degenerative: This is a chronic stage where the tendon has significant damage and may not heal properly on its own.

Insertional vs. Mid-Portion Tendinopathy

Achilles tendinopathy can be classified into two main types based on its location:

Insertional Tendinopathy: This occurs where the tendon attaches to the heel bone. Compression of the tendon in this area is a big issue. Treatment involves reducing this compression and avoiding stretches that might aggravate the area.
Mid-Portion Tendinopathy: This affects the middle section of the tendon. Management here focuses on different strategies, such as eccentric loading.

Insertional vs. Mid-Portion Tendinopathy

Managing Tendon Pain

Isometrics: One effective method to reduce pain is using isometric exercises. These involve holding a position without moving, which can help ease pain and strengthen the tendon. Here's a quick guide:

How: Hold the position for 45 seconds.
How Often: 5 times.
Intensity: Up to 70% of your maximum effort.
Benefit: Can offer pain relief for up to 45 minutes.

Why Isometrics? They allow you to apply force without moving the joint, which can be less painful and more effective for strengthening weak spots. Plus, they can help increase tendon thickness and stiffness if done with the right intensity (70-100% of your maximum voluntary isometric contraction).

EXAMPLE EXERCISE:

PROGRESS:

Eccentric Loading

Eccentric exercises involve lengthening the tendon while it's under tension, which can help with healing and strengthening. Here's how to do it:

Exercises: Perform straight leg and bent leg raises.
Reps/Sets: 3 sets of 15 repetitions per day.

Heavy Slow Resistance Training

This involves lifting heavier weights slowly to strengthen the tendon:

How: Lift weights with a 3-second up and 3-second down motion.
Reps/Sets: 3-4 sets of 6-15 reps.
Frequency: 2-3 times per week.
Progression: Start with 15 reps max and work your way down to 6 reps max over 12 weeks.

Load Management

Pay attention to these factors when managing your load:

Volume: The total amount of exercise you do.
Intensity: How hard you’re working.
Frequency: How often you exercise.
Type: The kind of exercise (compressive, tensile, or a mix).

Allow 24-36 hours for recovery between sessions.

Practical Tips for Managing Tendinopathy

Here are some practical tips to help manage Achilles tendinopathy in everyday life:

Heel Raises/Footwear: Use these for insertional Achilles issues.
Adjust Running Frequency: Run every other day instead of daily.
Modify Workouts: Reduce hills and speed work.
Separate Exercises: Keep isometric exercises and running separate when possible.

By understanding these strategies and adjusting your training and lifestyle accordingly, you can manage and even overcome Achilles tendinopathy. Remember, consistent and appropriate management is key to a full recovery! At Move Sports Physio in Geelong we have you covered, and will set you up with a clear plan how to progress your loads and strength and return back to function.