Achilles tendon problems are common in many running and jumping sports. Acute tendon ruptures can occur, however the majority of tendon problems are overuse injuries.
Many so-called 'achilles tendinitis' problems are not truly an inflammatory condition, so are now medically termed 'achilles tendinopathy'.
These injuries are usually strongly related to numerous contributing factors:
1. Tight calf muscles
2. Poorly fitting shoes or shoes that do not control pronation adequately. This also includes old shoes that have logged more than 600 kilometres. By this stage shoes have lost more than 30% of their compressive and supportive abilities.
3. Sudden changes in running speed / intensity
4. Dramatic change in running terrain eg: sand / hills
5. Poor eccentric calf strength or 'turnaround'
6. Tight sciatic / neural tissue
7. Foot biomechanics eg: overpronation / stiff ankle joint
Accurate diagnosis is needed to exclude numerous other conditions that may mimic achilles tendinopathies.
Adolescents (generally 8-15 year olds) may also present with Sever's disease (traction apophysitis of the heel growth plate). This self-limiting condition may require sports participation modification or reduction, however thorough management should see an early return to normal sporting activities.
A treatment plan is decided on after establishing the severity, chronicity, contributing factors and cause of the achilles tendinopathy.
Treatment may include:
- heel raise inserts
- eccentric “heel drop” exercises
- proprioception retraining
- lower limb / core control exercises
- training advice
- footwear advice
Recent research is now finding tendon injuries may take significant time to completely heal. The collagen fibres in tendon tissue undergo complex changes and require appropriate 'eccentric loading' exercises to provide efficient healing. Rest alone is not usually an option.
Prevention is better than cure so, choose your shoes wisely, prepare your body optimally and increase training loads gradually!