Achilles tendonitis or tendinopathy
It's an irritation of the Achilles tendon.
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What is the difference between tendinitis and tendinopathy?
The two are almost identical.
Science has recently discovered that there isn't always inflammation present in tendon pain.
"So when there is tendon pain without inflammation, it is called tendinopathy. When there is tendon pain with inflammation of the tendon, then it is called tendinitis."
In both cases, whether it's tendinitis or tendinopathy, the treatment approach isn't very different. Therefore, we will include tendinopathies and tendinitis as the same injury.
What is Achilles tendon tendinopathy?
It's an irritation of the Achilles tendon.
What is the Achilles tendon?
It's the tendon of the calf muscle that attaches to the heel at the back of the foot.
What are the causes of Achilles tendon tendinopathy?
This can be caused by:
- Too rapid an overload on the tendon
- Small, repetitive traumas to the tendon
Here are some classic examples of the development of this pathology:
- Resuming running after winter without proper pacing
- Changing a parameter of your running (speed, elevation, distance)
- Starting to walk a lot when you weren't walking regularly before
- Starting a new sport that involves a lot of jumping (volleyball, basketball)
What are the symptoms of Achilles tendon tendinopathy?
The most common symptoms are:
- Pain that appears gradually behind the heel in the center, or pain in the tendon between 2 and 6 cm above the heel.
- The pain is worse with the first steps in the morning or after being still for a long time.
- The pain improves with movement but returns if you do too much weight-bearing activity, such as:
- Walking (worse when going uphill)
- Running (worse when going uphill)
- Rise up onto your toes.
- Jumping
- Pain when the tendon is pinched
How is Achilles tendinopathy diagnosed?
Diagnosis is possible based on the history of your symptoms and a clinical examination. X-rays cannot detect tendinopathy.
When should I see a physiotherapist for Achilles tendinopathy?
You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.
You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.
What physiotherapy treatments are available for Achilles tendinopathy?
Your physiotherapist will perform a thorough assessment to determine the precise source of the problem. There are various causes of Achilles tendinopathy.
Your physiotherapist will assess the following:
- Your joint mobility
- The gliding of your nerves
- The quality of your movements
- Your strength and stability
Based on the assessment results, your physiotherapist will:
- Mobilize your joints, muscles, and nerves to reduce pain and improve movement.
- Provide you with specific exercises to retrain the strength and stability of your foot.
- Give you specific exercises to learn how to properly control your movements.
- Teach you how to properly manage your daily activities and hobbies to optimize healing
- Give you advice for your posture and movements.
What to do at home for Achilles tendinopathy?
Reduce the duration of activities that cause too much pain temporarily, and then gradually begin to increase the duration afterward.
If you are a runner, please refer to the blog post on running (link to come) for practical running tips.
To learn more...
You can listen to the podcast PARLE-MOI DE SANTÉ created by one of our physiotherapists, Alexis Gougeon.
Episode #1 discusses the prevention and treatment of running injuries.
Find the episode on YouTube:
Click below to listen to episodes on podcast platforms:
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Sources
Martin RL, Chimenti R, Cuddeford T, Houck J, Matheson JW, McDonough CM, Paulseth S, Wukich DK, Carcia CR. Achilles pain, stiffness, and muscle power deficits: midportion Achilles tendinopathy revision 2018: clinical practice guidelines linked to the International Classification of Functioning, Disability and Health From the Orthopaedic Section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy. 2018 May;48(5):A1-38.
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