So perhaps you recently returned back to playing soccer. After a few weeks of playing you notice pain along your lower leg and heel during and shortly after the game. A few more weeks later this pain gets worse and even bothers you the next morning after soccer. Unfortunately as the season continues the pain gets worse. This may be caused by a condition called achilles tendonitis. Let’s learn about achilles tendonitis and what you should do about it.
What is it?
The achilles tendon is the band of tissue that connects the calf (muscle in the back of the leg) to the heel bone. Achilles tendonitis is an overuse injury of the achilles tendon. Repetitive stress from an activity will cause micro tears and inflammation in the achilles tendon. Recent research has shown that achilles “tendonitis” may be more correctly termed achilles “tendinosis”. Tendinosis is a degeneration of the tendon due to repetitive stress of an activity. Fortunately whether or not it is termed achilles tendonitis or tendinosis the treatment is similar and equally as effective. The cause of this issue is usually due to overtraining which is when you train too hard and too fast. This overtraining overloads the achilles tendon causing achilles tendonitis/tendinosis.
What are the signs and symptoms?
-pain in the tendon during or after an activity such as walking, jumping, or running.
-pain the next morning after the activity from the day before. Discomfort is often reduced after walking around for a few minutes.
-discomfort when walking after a period of sitting.
-pain along the attachment of the tendon onto the heel is known as insertional achilles tendonitis
-pain along the middle of the tendon is referred to as non-insertional achilles tendonitis
How is it treated?
Your physiotherapist will work with you to massage and stretch the calf muscles and achilles tendon. Acupuncture and dry needling will also be effective at reducing the tension in this area. If over training is the cause of your issue it is important to reduce the volume or even perhaps take a short break to allow your leg to rest. Proper footwear is also important to consider. Your physiotherapist will assess your foot and advise you on the type of shoes you should wear. If you have flat feet or a high arch you need a pair of shoes that fits your foot properly. Your foot and achilles tendon absorbs a lot of force when you run or jump and the proper pair of shoes for your feet will help absorb those forces evenly. Your physiotherapist will also prescribe you foot exercises and jumping exercises to help strengthen and condition your achilles.
Common home exercises
Single Legged Romanian Deadlifts
This balance exercise helps strengthen the muscles in the foot and lower leg. Stand on one leg. Bend forward reaching both arms forward and kick one foot backwards. Try your best to bend forward at your hips and keep your knee fairly straight. Stand back up and repeat. This is a balance exercise so if you fall during a repetition you must repeat it again.
Start with both feet on the ground. Stand up onto your tippy toes to engage your calves. As your Achilles feel better progress to doing single legged calf raises using only the affect foot.
Jumping jacks/ Single legged hops
Jumping exercises will introduce a plyometric load to your achilles. This is important if you want to return to running and playing sports. You will start with jumping jacks. As you are feeling less pain with jumping jacks progress to single legged hops on the affected foot.