Introduction
Achilles tendinitis (or tendinopathy) is a common and painful condition that we frequently see here within the clinic, that may consist of pain, swelling and limited mobility around the achilles tendon and heel area. Achilles tendon problems are one of the most common types of over-use type injury, but the pain itself may actually develop very quickly, or gradually over time.
Achilles tendon problems are thought to affect up to 9% of runners, and around 5% of professional athletes, however it can also develop in those who are overweight, less active and more elderly.
Cause of the injury
Although the people we often see with achilles tendon problems are caused through overuse, or overloading of the tendon in some way, there are a number of separate identified causes some of which are listed here:
- Increased running distances or hill training
- Poor shock absorption (footwear related)
- Problems with foot alignment and positioning
- Differences in leg length
- Other biomechanical foot issues
- Increased age
- Corticosteroid use or recent use of some types of anti-biotics
- Obesity
- Diabetes
- Auto-immune conditions
This is why a thorough consultation is always necessary when seeing a Chiropractor, or other healthcare professional, in order to decide upon the correct course of action.
Achilles Tendinopathy or Tendinitis?
Generally these terms are actually used interchangeably when talking about achilles tendon problems. Each one however does have a slightly different meaning :
- When the achilles tendon is painful and also showing signs of inflammation (such as redness and swelling), this is described as a ‘tendinitis’
- When an achilles tendon is painful but not showing those signs of inflammation we may refer to this as a tendinopathy.
Fortunately, the management of these problems is actually fairly similar, the options for which are outlined below.
How to deal with my achilles tendon problem- treatment options
Fortunately, many case achilles tendinitis issues do in fact resolve gradually and heal over many months, but there are various treatment options available for these sorts of conditions, with varying amounts of benefit.
The first thing is to discuss and then aim to reduce any of the potential risk factors outlined above, where possible, which will largely depend on the person. Chiropractors, Osteopaths and Physiotherapists are trained to assess and help address any foot, ankle or bio-mechanical issues that may be a contributing factors. The Chiropractors at Skelian in Bristol will also aim to give you some practical advice to help manage the pain on a day to day basis.
If treatment is deemed appropriate, there are a number of options available, which will be discussed with you at your initial consultation. It will however depend on what stage of the injury and healing process you are at as well as all your individual factors involved. Some commonly used treatment options and management approaches are:
- Initial rest in more acute cases
- Correction of any foot alignment issues through orthotics is thought to be helpful if appropriate
- Shockwave therapy has been shown to have a success rate of around 70% for achilles tendinitis/tendinopathy cases
- Deep friction massage or “cross-friction” across the tendon itself
- A gradual, graded return to exercise and loading is often advised
- A strengthening phase done as an “eccentric loading programme” where the calf muscles are loaded whilst the tendon is elongated
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5112330/
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