Achilles Tendinitis and Tendinopathy can be quite debilitating, however physiotherapy treatment can help! Physiotherapy has been shown to be a safe, and effective treatment for Achilles Tendinitis/Tendinopathy. In this article we will explore what Achilles Tendinitis and Tendinopathy is, why it occurs, and how physiotherapy can help.

What is Achilles Tendinitis or Tendinopathy

The Achilles tendon is a large tendon that attaches your calf muscles to the back of your heel. Achilles Tendinitis or Tendinopathy (more chronic version) is the inflammation and degeneration of the tendon. It can be associated with pain at the back of the heel or into the calf, swelling around the Achilles, and weakness of the calf muscles (going up onto your toes can be difficult). 

Why Does It Happen

Often people with Achilles tendinitis/Tendinopathy have a chronic shortening of the gastroc/soleus complex, which are your big calf muscles. There are many reasons that our calf muscles shorten over time, such as the shoes we wear, the activities we do, our ankle mobility, and many others. During the physiotherapy assessment, we examine the flexibility and strength of these muscles. At Move Authentically Physiotherapy we pride ourselves on trying to find the root cause of the condition. Perhaps, there is something contributing to that tightness from higher up the chain (knee, hips, low back), which may relate to work positioning, posture, footwear. 

If the calf muscle complex is shortened, it creates constant pull or stress on the tendon that attaches these muscles to the bone. Once it reaches a point, simple daily activities such as walking, running, getting up after sitting for a prolonged period of time, and taking the first few steps in the morning, can be excruciating.   

Physiotherapy and Achilles Tendinitis/Tendinopathy 

There are many different things that Physiotherapists can do to help you through this painful and often debilitating injury. 

1. Mobility 

First, we need to address any mobility issues, such as the calf muscles themselves. Also, any of the mechanics from the lower back, pelvis, hip, knee and ankle can influence how much load the calf muscles are under. Therefore, these areas may be treated as well. 

2. Strength and Stability 

After we regain mobility, we need to work on strength and stability. There is no point in strengthening within a small range of motion, therefore we regain your mobility first, then re-load the tissue through strengthening. Besides the obvious of strengthening the calf muscles, you may need to focus on the small intrinsic foot muscles, perhaps even the lower back/pelvis/hip complex. 

3. Function

Once mobility, strength and stability have been achieved, we move onto the functional stage. Transitioning from training muscles individually to bigger, global movements that challenge the muscles in a more functional capacity to ensure you get back to your normal activities.