Dealing with Achilles tendonitis

Achilles tendonitis is an irritation and inflammation of the large tendon in the back of the ankle. Achilles tendonitis is a common overuse injury that tends to occur in running and jumping sports like football and basketball.

Symptoms
Symptoms of Achilles tendonitis:

• Patients will usually experience pain generally about 5cm above the heel bone. Occasionally pain is in the back of the heal

• Swelling, tenderness and warmth of the Achilles tendon

Degrees of severity
Achilles tendonitis is graded according to how severe it is:

• Mild – pain in the Achilles tendon during activity (such as running or jumping) or shortly after.
• Moderate – the Achilles tendon may swell and become extremely tenderness to the touch. Pain is accompanied by stiffness, especially at the first step in the morning, or rising after long periods of rest. In some cases, a hard lump (nodule) may form in the tendon.
• Severe – any type of activity that involves weight bearing causes pain of the Achilles tendon. Very occasionally the Achilles tendon may degenerate and rupture (tear) if not managed.

Common causes
Some of the causes of Achilles tendonitis include:

• Overuse injury – most common cause of Achilles tendonitis, this occurs when the tendon is stressed until it develops small tears. Runners and footballers seem to be the most susceptible. People who play sports that involve jumping, such as basketball, are also at increased risk
• Foot problems – some people with flat feet or hyperpronated feet (feet that turn inward while walking) are prone to Achilles tendonitis
• Footwear – wearing shoes or boots with minimal support while running can increase the risk
• Overweight and obesity – being overweight places more strain on many parts of the body, including the Achilles tendon

Injury Management
Achilles tendonitis is a condition that responds well if treated appropriately at an early stage. If symptoms are disregarded severe tendon degeneration can develop. In these cases, treatment and rehabilitation can take several months and even up to a year to heal.

The aim of the treatment is to reduce strain on the tendon and reduce inflammation. Strain may be reduced by avoiding or limiting activities that may aggravate the condition, such as running. Trying to ‘work through’ the pain will only make your injury worse. Inflammation may be reduced by applying icepacks for 15 minutes after activity.

Professional Help
If the pain in your Achilles tendon that you are managing yourself does not improve over a few days, it is best to seek medical advice and consult with a physiotherapist or health care provider to get an accurate diagnosis of the injury and suggest the most appropriate treatment plan.

Physiotherapy provides rehabilitation and support
Physiotherapy treatments may include:

• Hands on therapy for damaged tissues
• Gentle exercise program to stretch the calf muscles
• Exercises to improve mobility of the foot and ankle joints
• Exercises to strengthen the calf and Achilles tendon once the acute stage of inflammation has settled down
• Advice on taping to support the arch of the foot or heel supports to take pressure off the Achilles tendon

Prevention
Suggestions to reduce your risk of Achilles tendonitis include:

• Incorporate calf stretching into your warm-up and cool-down routines
• Maintain an adequate level of fitness for your sport
• Avoid dramatic increases in sports training
• Wear good quality supportive shoes appropriate to your sport
• Maintain a normal healthy weight

If there are any further questions regarding this topic or areas of interest you would like covered in future editorials please contact either a Jubilee Sports Physiotherapy clinic or email office@jubileesportsphysio.com.au.

This information is provided to Sutherland Shire Football Association by Jubilee Sports Physiotherapy as part of its commitment to Shire football and the SSFA.