Types of Achilles tendinopathy?
First off, it is important to establish exactly what is causing the problem and exactly what type of Achilles pain you have. There can be several other reasons why you may be getting Achilles symptoms, but for the purpose of this article, we will concentrate on the most common.
Recent studies have shown that injury rates are as much as 29-58% in new runners. It’s also estimated that 60-70% of running injuries are due to overuse or training error.
In other words, don’t just concentrate on the painful point! Rehabilitation from an injury can be complicated and unless you’re addressing the root cause of the problem, it’s likely to come back! This is why seeing a physio can be useful: we can help you to understand the reasons for your symptoms and help you address the imbalance and weakness which may lead to injury.
Mid Portion Achilles Tendinopathy
The most common cause of Achilles pain is mid-portion Achilles tendinopathy. This commonly affects the Achilles 2-7cm above the bony point at the back of the heel. Typically, this is likely to appear swollen, be tender to touch and will often cause pain and stiffness first thing in the morning and when weight-bearing.
Insertional Achilles Tendinopathy
This condition is less common but still a prevalent problem that I see in the clinic. The key difference between the two is that mid-portion tendinopathies are commonly caused by tensile loading and insertional tendinopathies are caused by compression.
The main presentation for the insertional kind is a pain at the heel bone where the Achilles attaches and pain with the ankle flexed to stretch the tendon i.e. the position of the foot when walking up a steep hill. This position of the foot is what causes the compression and aggravates the symptoms – and why exercises that exacerbate this should be avoided!
Below I will outline the best way to manage these conditions, along with links to some self-help videos for exercise and pain management. However, it’s probably worth mentioning at this stage that these are only to be used as a rough guide and if you are unsure about your condition please book yourself in for a physio consultation. The first appointment is free! And it may help you avoid getting it wrong and potentially delaying your healing time.
Now that you have a rough idea of why you have tendinopathy, you now need to figure out what stage of tendinopathy you are dealing with. To avoid going full physio geek on you, we’ll keep this simple and concentrate on two phases of tendinopathy, the first being the reactive type and the second being the degenerative tendinopathy.
Phase One – Reactive Tendinopathy
Commonly caused by an increase in loading exercise, for example trying to run faster or further than you’ve ever done before…we’ve all done it! This will typically cause pain during or after the activity and may be exacerbated first thing in the morning or during weight-bearing activity.
The key to your management at this stage is to reduce the load that you’re putting through your Achilles and try and calm the symptoms down. It’s pretty simple: if you carry on doing the same thing at the same pace and effort then you are likely to make it worse!
Phase Two – Degenerative Tendinopathy
At the tender age of 41 and having played sports for most of my life, sadly I would fit into this category. In fact, I would say it is almost normal to have a degenerative tendon somewhere in your body if you’ve been active for most of your life, especially with high impact sports such as running, football, netball and basketball. So do not fear – this is common!
Basically, if you’re older and have a previous history of Achilles pain and a grumbly tendon that is prone to flare-ups, it’s likely that you will also fit into this category. The typical presentation is a thickened tendon, which is painful to touch and is often sore first thing in the morning and during weight-bearing activity. Again, load management is important. If you keep aggravating it, there is potential to make the situation chronic and potentially lead to a partial or full Achilles rupture.
It is also possible to have a reactive, degenerative tendon. An example of this would be a 60-year-old man who has a history of Achilles pain with symptoms which have been under control for several years, but a recent increase in tennis has caused his degenerative tendon to become reactive. If this is the case with you, then start your management at the reactive phase i.e. reduce the load, pain management, rehab exercises then graded return to activity. Tendons are complicated and there is no one recipe for treatment. Finding the right treatment is an important part of your recovery.
Get started today with a free consultation…[online_booking_btn type=”orange” size=”lg”]Book now[/online_booking_btn]
Recent Posts on Sports Injuries …
- How to Reduce Your Risk of Sports Injuries 17th May 2021 If you play sports long enough, you are bound to suffer an injury. Here are a few tips to reduce your risk and stay in the game. To an athlete, there’s nothing worse than being sidelined with an injury. Improper training, incorrect stretching routines, and a lack of a good warm-up can lead to an increased ...
- Why Pro Athletes Choose Chiropractic 10th May 2021 For over 100 years, professional athletes of all kinds have used chiropractic care to recover, reduce their likelihood of injury, and even get an edge in performance. And what used to be a secret is now well-known. Chiropractic care is used by sports teams from high schools right up through to the pros. Why it Matters: Historically, ...
- Staying Healthy as a Weekend Warrior 4th May 2021 Millions of people participate in sport each weekend as a way to stay active and stay connected to their friends… but, inevitably, as we age, the likelihood of an unexpected injury creeps up. So how can you stay healthy as a weekend warrior? Taking proactive steps during the week to stay well can directly impact your ...
- Brighton Half Marathon runners’ offer 5th February 2020 The Brighton Half Marathon is in just over two weeks time and we are entering a team as well as sponsoring the event with our Massage Tent. It might be a bit late to enter if you don’t run regularly as one of our previous team members found out. Becky had never attempted 13.1 miles ...
- Runners MOT – Brighton Half Marathon 20th January 2020 Running injuries often start with a niggle. Knee pain, muscle strain, tendon pulls, bursitis, ligament sprains and all sorts of other aches and pains are a constant reminder that marathon training and actually running it can be a hazardous business. Many people who enter for the Grand Brighton Half Marathon will not complete it because ...
- Achilles tendon pain – Step by Step Guide to Recovery 20th January 2020 Achilles tendon pain - Step by Step Guide to Recovery
- Achilles tendon pain? Which type do you have? 4th December 2019 Achilles tendon pain? Which type do you have?
- Brighton half marathon recovery tips: how to manage an acute injury 18th November 2019 Brighton half marathon recovery tips: how to manage an acute injury
- Brighton Half Marathon runners’ offer 27th February 2019 After running the Brighton Half Marathon on Sunday you may still be getting muscle soreness or other aches and pains. Simple muscle soreness will get better over the next few days and massage can help speed this up. If you have a more persistent or painful niggle then you probably want to know whats wrong ...
- How to manage an acute injury yourself 29th February 2016 “As a physiotherapist this is a question I get asked a lot and having just completed the Brighton Half Marathon you may be asking the yourself the same question.” says Sundial physio James Masterson. He goes on to say “So in order to help you with your post run recovery here’s a few useful tips to ease you back ...