The achilles tendon is the thickest tendon of the back of the leg. The calf muscles of the back of the leg, to include the plantaris, gastrocnemius (calf) and soleus muscles, come together and form the achilles tendon. The achilles tendon then inserts onto the calcaneus bone, which is considered the heel region. These muscles, acting via the tendon, cause plantar flexion of the foot at the ankle, a.k.a. they point the foot.
Achilles tendinopathy is a condition that causes pain, swelling, stiffness, and irritation of the Achilles tendon. The achilles tendon may be injured gradually due to overuse or by a sudden injury. Damage to the tendon occurs in the form of small tears and hence becomes a “tendinopathy.” Symptoms of achilles tendinopathy include pain and irritation and it may be difficult to walk, run, and perform stairs. Ankle stiffness may also be present. The tendon may become tender to the touch and may be thickened and swollen as well.
Physical therapy can help relieve the pain of achilles tendinopathy and help restore your strength and range of motion. In the meantime, one may be asked to avoid activities that stress the tendon such as running or climbing stairs. A full assessment is necessary to determine to what degree is the tendinopathy.
Manual therapy is very essential to re-establish the health of the tissue in this region. Manual therapy is considered to be any skilled technique performed with one’s hands that are intended to mobilize the joints and soft tissue structures in order to improve tissue extensibility or range of motion, modulate pain, and/or reduce swelling or restriction. Often, the tendon is thickened and no longer in the proper fiber alignment. For this, deep friction mobilization is necessary to repair the tendon. The calf muscles higher up above the tendon (more proximally) may also be very tight and thus need to be released.
Eccentric strengthening is also very important in order to heal the tendon properly. Eccentric muscle action is when the muscles lengthen as it develops tension and contracts to control the motion performed by an outside force. For this example, your calf muscle shortens and contracts (concentrically) when you rise onto your toes and then lengthens (eccentrically) to control your descent. The lowering phase is an eccentric contraction. This is often an exercise that is prescribed by a physical therapist in order to rehabilitate from achilles tendinopathy.
If you are experiencing achilles pain or dysfunction, it is a great idea to get a comprehensive examination by a physical therapist as soon as possible. Often, the longer you wait the worse the issue. If not addressed, this can cause severe damage and possibly even a rupture of the tendon. It can also cause other issues in the body as a result of improper movement and compensations.
Go see your physical therapist today and begin the process to get back to 100% today! There is no better time than the present.