Achilles Tendinopathy is a health condition that affects the Achilles tendon. It presents in up to 1 in 5 high level runners and an estimated 2 in 1000 people in the general population.
Tendons are designed to resist tension and transfer force from muscle to bone to allow movement. As we exercise and use our muscles tiny amounts of micro damage occurs to the tendon, then when we rest, the tendon has the chance to heal and become stronger. However, when there is a sudden increase in loading such as increased training for a marathon the amount of micro damage occurs at a faster rate than the repair. As the tendon attempts to heal itself it becomes thickened to increase the surface area and has nerve ingrowth causing pain. As the process of loading and reduced healing time continues, the tendon becomes more damaged and painful and if left too long can get to a point where it becomes very difficult to heal and permanent damage can occur.
Most people describe their symptoms as a gradual onset of pain over time at either the mid portion or the base of the Achilles. Most will report the pain beginning after a change in activity whether that be an increase in distance, new activity, change in surface, or increase in intensity. To begin with, symptoms of Achilles Tendinopathy includes pain at the beginning of an activity that settles once the muscles have warmed up and then pain can appear again after a cool down period. As it progresses the Achilles can become painful during activity. Another common sign is pain and stiffness in the morning when you first get out of bed. Dependent on the stage of the injury the tendon may appear red and thickened and will be tender to touch at about half-way up the tendon. You may also find it painful to stretch your calf and to do a calf raise.
Research has shown that progressive exercise therapy is the best method for managing Achilles Tendinopathy. At Cairnhill Physiotherapy, we generally begin with light isometric exercises and pain relief, then progress to more dynamic loading. The recovery time frame can be influenced by several factors including age, previous level of activities, and stage of tendon damage to name a few. Because of these varying factors, an exact recovery timeframe is hard to provide. Most patients follow a 12 week program that includes therapist input and self-management and you would expect to see positive changes throughout that time.
Physiotherapy plays a vital role in the management of Achilles tendinopathy. At our Auckland Physio clinic, our team can assist with pain management in the acute phase of recovery, design a patient specific program to allow for the best possible recovery and monitor and adjust the program as necessary.
The short answer to this is no. Although rest may help to reduce your pain, it will not help to heal the tissues that have been damaged and it is likely that as soon as you return to an activity that puts demand on the tendon, your pain will return. The good news is that you don’t need to completely stop the exercises you enjoy. At Cairnhill Physiotherapy, we can help you to create a plan to allow you to recover fully and get back to doing what you enjoy.