Achilles tendonitis, sometimes known as Achilles Tendinopathy or Achilles Strain, is often the result of many small tears in the substance of the tendon or its covering. Many sports, including walking, hiking, running, football and netball strain the tendon and cause the fibres to break down. Perth Physiotherapy and Sports Injuries Centre can help you with the diagnosis and treatment of achilles tendonitis.


CAUSES OF ACHILLES TENDONITIS


Under-training

During training, our body adapts to the increased load of the activity by thickening and strengthening tissues to cope with the increased strains. If a tissue such as the Achilles tendon is heavily or repeatedly loaded, for example when sprinting but has not had enough training to allow it to cope with these loads, it will develop a tendonopathy, commonly known as a tendonitis during the inflammatory phase. An example would be the office worker who plays football at the weekend but has not trained during the week.

Over-training

Our body adapts to the increased load of training by thickening and strengthening tissues to cope with the increased strains. If a tissue such as the Achilles tendon is heavily or repeatedly loaded without enough time to recover and heal, it will break down and may develop a tendonitis. Over-training and over-use, occur in repetitive sports, such a football and distance running and over zealous training in any fast moving sport.

Over-load

Our Achilles tendons are elastic to a degree and when properly trained are strong and resilient. When there is a sudden acceleration or deceleration which suddenly stresses the tendon to a load greater than it can cope with, it will pull apart creating micro-tears which become inflamed as they attempt to repair. Most tears are partial tears, known as strains but sometimes the tendon will completely tear and this is called an Achilles rupture. Overload injuries often occur playing tennis, squash, during all football codes and athletics and are due to:-

  • Inadequate warm up
  • Inappropriate training and conditioning
  • Faulty biomechanics such as weakness, poor muscle flexibility and joint stiffness
  • Previous and now chronic injury

The Physiotherapist will identify and correct any factors which have contributed to the development of the injury.


SYMPTOMS OF ACHILLES TENDONITIS


There may be stiffness and ache in a gradual onset over use injury and severe pain with a tear injury. Generally pain and stiffness is mild initially with a slow onset training type injury and acute strong pain occurs with more widespread tears and inflammation. The more rapid the onset, the greater the inflammation.


DIAGNOSIS OF ACHILLES TENDONITIS


The diagnosis and choice of Achilles tendonitis treatment will need to be made by a Physiotherapist. A thorough examination is sufficient to diagnose the tendonitis and other investigations such as an ultrasound scan, will be arranged if extra information is required.


TREATMENT OF ACHILLES TENDONITIS


Achilles tendonitis heals best when treatment has begun as soon as practical following injury. The sports person must immediately stop the sport and avoid any movement which produces the pain. In the case of sudden onset pain, the RICE protocol should commence. This is:-

  • Rest:                 Rest from aggravating movements to reduce further bleeding and injury.
  • Ice:                    Real ice wrapped in a wet towel and applied to the injury for thirty minutes.
  • Compression:  The calf may be bandaged to reduce swelling but not during sleep.
  • Elevation:         The leg may be elevated to a 45 degree angle to drain swelling.

Medications

Pain killers may be needed initially and anti-inflammatories may be used after 48 hours when bleeding has stopped.

Advice regarding

  • The injury diagnosis
  • Anti-inflammatories and pain killers
  • Compression bandaging

Direct Physiotherapy Achilles Tendonitis Treatment

  • Ultrasound and other electrotherapy
  • Stretches
  • Soft tissue treatment
  • Joint mobilisation
  • Exercises to regain strength, movement

Physiotherapy Management of Return to Sport

  • Correction of biomechanical anomalies
  • Technique modification
  • Provision of orthotics and footwear advice
  • Providing a return to sport plan

Management may require the use of crutches or a walking stick to reduce the load on the tissues. As the injury begins healing, the Physiotherapist will advise a graduated return to exercise program without an increase in symptoms. Depending on which tissues are injured, there will be stretches, strengthening and mobility exercises to return full function and reduce the chance of the injury recurring.

In the event of a severe injury where Physiotherapy is not appropriate, the patient will be referred directly to a doctor and on to the appropriate professional for further investigation and treatment. In the event surgery is required, Physiotherapy rehabilitation will be arranged afterward.


PROGNOSIS OF ACHILLES TENDONITIS


Achilles Tendonitis recovers well with Physiotherapy management. Full recovery may take some time, depending on the extent of the injury. The goals of Achilles tendonitis treatment are to achieve the best quality healing with a pain free, full range of movement and normal function, so there is minimal likelihood of a recurrence in the future.

Phone us now on (08) 9481 7677 for your Physiotherapy assessment and we will tell you how we can help you, or click here to contact us for more information about Achilles tendonitis treatment in Perth. Patients from all over Western Australia choose the Perth Physiotherapy and Sports Injuries Centre in the Perth CBD.

Contact Us

Go to top