ACHILLES TENDINOPATHY
E-BOOK


Managing Achilles injuries in 2022: Everything you need to know and why you might not be progressing in your rehab

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If you are a runner, or engage in any running or walking based activity, there is a fair chance that you, or someone you know, has experienced some form of achilles pain.

 

The reason I can say this so confidently is because 52% of elite runners will experience an onset of achilles tendinopathy throughout their lifetime. This means that greater than 1 in 2 of these runners will have an issue with their achilles!

 

Now I know that we all don’t run 80-160km+ per week, however we know that injuries of the achilles are closely related to load accumulation over time. So simply put, those who are highly active throughout their lives, are more likely to develop symptoms.

 

The frustrating part…for an issue that is so common, we often disregard or mismanage our symptoms.  Too often we see tendon pain disregarded as “only a niggle” at first. Yet pain is the achilles’s way of telling you that it is not coping with the current demands and they need to change. Addressing this early can mean a quicker recovery without drastic changes to activity and routine.

 

However if neglected, this can lead to longer periods of time off activity and a more prolonged recovery outlook. Therefore it is with the health of achilles everywhere, as well as the love of seeing happy, active people doing what they love, that I hope this E-book can help give you the initial tools and inspiration to address your achilles pain.

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The Achilles is the strong, fibrous tissue (think thick, powerful rubber band) that runs from the base of your heel and inserts into the muscles throughout the back of your calf, mainly the soleus and gastrocnemius muscles. 

 

The main role of the tendon is to store and release energy throughout our walking and running gait. It is because of this, and the loads going through it, that the achilles tendon is the largest and strongest tendon in the human body.

Common areas of pain associated with the achilles tendon:

 

Insertional

  • Pain on lateral calcaneus (outside of heel bone)

  • Can often involve irritation and thickening of the retrocalcaneal bursa (fluid filled sac under tendon)

  • Higher predisposition in cavus foot types (higher arches) with associated haglund deformity (bump on the back of heel)
     

Mid-portion

  • Often pain during load or activity

  • Stiffness post rest

  • Thickening of tendon 2-6 cm proximal to the tendon's insertion (away from the heel bone)
     

Plantaris

  • Pain medial (inside of tendon) and quite high 

  • Pain at top range of calf raise (when on tippy toes)

  • Pain when transitioning from high to low in calf raise or hop
     

Peri-tendon

  • Diffuse (all over the tendon)

  • Notable acute thickening of the tendon

  • Typically presenting 2-6 cm proximal to the tendon's insertion (away from the heel bone)

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