Achilles Tendinopathy

December 14, 2018

With 2019 just around the corner I thought it would be a good time to discuss an injury that we commonly see with a sudden increase in exercise. This is normally the case with a News Years resolution after indulging in all the lovely food and drink over the holidays. The injury I am going to discuss is Achilles Tendinopathy.
A Tendinopathy is usually a result of your tendon not having the capacity to tolerate what you are trying to do with it. And therefore begins to change in structure and become painful. A common cause of poor capacity of the Achilles tendon is weakness of your planter flexors (calf and soleus). How do I know if my planar flexors are weak?

A simple test shown above is to see how much capacity the muscles have. Single leg heel raise with your knee bent and then straight. Test both sides to see if they are the similar. Make sure they are good repetitions with good heel height which remains throughout the test. A good score is generally between 35 and 40 repetitions however this does vary slightly dependant on age.
What to do if I find weakness?
Above are some exercises to try. You should aim to complete the exercises 2-3 times weekly having a rest day in between. Aim for between 8-12 repetitions and perform 3-4 sets of each exercise. If you are able to complete 3-4 sets of 12 easily then increase the difficulty with extra load or single leg. The exercises shouldn’t be acutely painful however some discomfort should be accepted. The goldilocks principle allows us to monitor effectiveness of the exercise.
If after 24-48 hours after exercise:
No soreness – too cold – Work harder next time
Sore but eased – just right – Stick with it
Still sore – too hot – Do less next time. (Meakins 2017)

Managing your exposure to loading the tendon is also very important when increasing your running or exercise. With your running distance try not to increase your distance by more than 10% weekly. Including strength training alongside your running is also important in reducing your risk of injury.
Lastly be patient with your rehabilitation. Tendons can be stubborn and take some time to get right. You will have good days and bad days but don’t give up.

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