Our first blog on Achilles Tendinopathy or Achilles Tendon Injury focused on symptoms and causes. This blog will expand on Achilles Tendinopathy, outlining the actual anatomy of the Achilles tendon, and management of the injury.
The Achilles tendon is the thickest and strongest tendon in the human body. It connects the heel to the two calf muscles: the gastrocnemius and the soleus. The strong linear fiber arrangement of the Achilles tendon is encased in a strong sheath enabling the Achilles to transmit forces to and from the foot. The tendon itself has a very poor blood supply; hence it recovers slowly after injury.
In the Acute phase of achillies tendonopathy, treatment should begin with rest to allow the tendon to heal, ice to minimize pain and swelling, and the use of anti-inflammatory medication. Ultrasound therapy and manual mobilization of the Achilles tendon can be helpful in the promotion of local tissue and tendon healing, and will support tissue healing. It is also important to wear supportive shoes.
The sub acute phase also includes manual mobilization, as well as strengthening exercises. An eccentric strengthening program to encourage heeling is strongly recommended (refer to our first blog), as is stretching of the calf muscles. A night sock, such as the Strassburg Sock, can be worn to keep the tissue structures in a lengthened position over night and increase the rate healing.
In the last stage of management eccentric exercises should be progressed to further enhance healing and improve strength and control. Running footwear evaluation is necessary as shoes with poor support may exacerbate the tendinopathy. Sports-specific training is introduced gradually if there is no pain during and after exercise.
For another great video of an Eccentric Exercise for Achilles tendinopathy view the following link: https://www.physio4all.com.au/achilles-exercise-decline-board. It is the same exercise we linked to on Achilles Tendinopathy Part 1, but this time we have progressed the exercise with the use of a decline board.
Standing on the decline board, raise yourself up on your toes, and lift one leg up (this being the leg without the injury). Slowly lower yourself down, preferably to a slow count of 5, and repeat. You should feel the stretch going down your calf, and into your ankle/Achilles area.
For another exercise to strengthen the Achilles tendon, click on the following link: https://www.physio4all.com.au/achilles-tendon-exercise-2.
For a Straight Knee and Bent Knee Calf Stretch to help with flexibility, click on the following link: https://www.physio4all.com.au/straightbent-knee-calf-stretch/
To watch the Eccentric Achilles Tendon Exercise using a step, click on the following link: https://www.physio4all.com.au/eccentric-achilles-tendon-step/