The story of Achilles is that he was an ancient Greek warrior whos mother held him by the ankle and dipped him in the river Styx to make him invincible. However the place he was held became his vulnerable point or “Achilles heel”. Unfortunately for Achilles he was hit by an arrow in his heel by Paris and that was the end of him.
Hopefully none of us have to worry about being shot in the back of the leg. However many of us will at some point develop a grumpy tendon due to the nature of loading the tendon usually with running , etc and good old father time.
What does the Achilles tendon do ?
The Achilles is a very important part of how we move whether it be walking , running, sprinting, jumping and changing direction.
- It has to be strong enough to absorb the forces as our foot comes in contact with the ground.
- It then has to store the energy that it absorbs.
- Finally it has to release this energy to allow us to ” spring ” forwards.
The stronger and healthier the tissue the more efficient it is at doing this. This results in less energy required by us to propel ourselves forwards. If you want to see a great example of this the kangaroos have natures ultimate Achilles .
Its not running but this is a nice example of the Achilles as a spring in high jumpers
What happens in Achilles tendonitis or tendinopathy ?
Achilles tendon problems are best related to the following factors;
- The strength and fitness of the tissue.
- The state of the tissue.
- Mechanics at the lower limb and foot.
- Types of sport played and how much we have done .
How long does Achilles tendinitis take to get better ?
The answer is, as always, it depends. Whilst some can see rapid improvement within 3 months, for a lot of those with Achilles tendinopathy, it can take 3-6 months to see improvement, with full pain resolution sometimes taking over 1 year . In fact, in a study by Silbernagel, only 65% were totally symptom free at 5yrs .
What is the best way to treat your Achilles tendinopathy ?
Especially in the more resistant cases it is a good idea to get it assessed to work out what is the best way forward. Often the previously discussed issues have an impact on the health of the Achilles tendon and everyone is a little bit different.
However what seems to be critical is the following;
Tendinopathy and sudden increase in exercise or activity.
This is common in the ” masters” category of individual , i.e. those over the sunny side of 35-40 years in age.
It can be a very significant factor and may be a simple as suddenly increasing our daily steps from 5000 to 15000.
Or it can be a more aggressive than that by introducing a new form of exercise without building up to it e.g. adding jumping to a strength program, ( i personally stand accused and guilty of that).
Lack of strength and stiffness in the tendonitis / tendinopathy.
There are guidelines to what is the expected number of calf raises a person can do depending on their age and sex. You can check your exact numbers below and read more here.
This is very important as not only is it an indicator of how strong the muscle is but also how efficient and resilient the tendon and connective tissue structures are in performing their spring like tasks.
Remember kangaroos is what we want to be !
Lower limb and pelvic strength and Achilles tendinopathy / tendinitis.
Its not all about the Achilles. If you are lacking in strength or control in your hips, knee, pelvis and trunk then this can be an issue in the development of Achilles related injuries.
Also of concern is how the big toe moves when we walk or run. Too little movement has consequences not only at the ankle but also further up the leg.
These areas need to be “tidied” up for long term success.
Footwear and foot mechanics and Achilles tendinopathy.
If there are any alterations in the available movements at the foot this can negatively impact the soft tissue structures and especially the Achilles tendon. Especially if you are an avid walker, runner or sports person you need the right equipment and movement strategies to keep you on the pitch or track.
Due to this it’s a good idea to see if you need this attended to or if a change of footwear or orthotic is required.
For more info on podiatry and Achilles tendon check out this blog from dynamic podiatry
Nutrition and Achilles tendinopathy.
Previously we have written about how nutrition can help with tendon health and rehabilitation. The use of vitamin C and collagen seem to have very positive effects on the tendons strength. Read more here.
What’s the best exercise plan for Achilles tendinopathy / tendinitis.
So where to now ?
There are a few really good protocols that have had good results in the management of this condition.
The common thread between them is that they all involve strengthening the tendon complex using variations of calf raises using progressive loading and varying speeds and range of motion.
If you have any questions regarding a grumbly achilles tendon feel free to drop us a message or book in to see us.