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Achilles Tendinopathy

Achilles tendinopathy is a very common running related injury that we see at PhysioFit. You may be more familiar with the term achilles tendinitis which is inflammation in the achilles’ tendon but if you are suffering with your pain for more than 2 weeks you more than likely have tendinopathy. In this case the prolonged injury or inflammation leads to architectural changes in the tendon and overtime that leads to decreased force transfer in the tendon causing an injury. Ultimately, runners will increase their running volume or increase their speed causing increased load on the Achilles’ tendon. When that load exceeds the tissues capacity it leads to an injury. The goal of treatment is to increase tissue capacity while we slowly increase load and thus avoid an injury. Because we want to increase the capacity of the tissue the last thing we want to do is tell our runners to stop running or their tissue capacity will plummet. At PhysioFit we have a unique understanding of running related injuries and we differ from most other physical therapy clinics in that we find a running volume that suits you and your injury while we rehab you back to full running. Achilles tendinopathy rehabilitation is no different in that we will perform running retraining to deload the achilles’ tendon, perform dry needling/cupping to improve mobility, and then strengthening exercises to increase the load capacity of the tissue. In particular a recent study out of the UK showed that achilles tendinopathy was associated with a significant reduction in strength and endurance in the soleus muscle. The two videos below show 2 different patients performing eccentrics for the calf which is a beneficial technique to Improve the architecture of the tendon. The difference in the 2 videos is that one patient is performing from the ground (ankle neutral) which is important for insertional based achilles tendinopathy because it won’t respond well initially to dorsiflexion past neutral. The other patient has midportion achilles tendinopathy and is able to tolerate the eccentrics into large ranges of dorsiflexion. If you or anybody you know suffers from achilles tendinopathy or any other injury give PhysioFit a call!!

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