Achilles Tendonitis
Origin of Achilles Tendonitis
Achilles tendonitis is an overuse injury that occurs when the Achilles tendon, the thick band of tissue connecting the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus), becomes inflamed. This inflammation often results from repetitive stress, sudden increases in activity, or improper biomechanics, such as overpronation or tight calf muscles. Other factors like inadequate footwear, poor training techniques, or activities on hard surfaces can contribute. In some cases, structural abnormalities, such as a Haglund's deformity or bone spur, may irritate the tendon.
Benefits of Physical Therapy for Achilles Tendonitis
Physical therapy is highly effective for Achilles tendonitis and can offer the following benefits:
Pain Reduction: Physical therapists use modalities like ice, ultrasound, electrical stimulation, and soft tissue mobilization to reduce pain and inflammation.
Improved Flexibility: Targeted stretching of the calf muscles and Achilles tendon helps restore flexibility, reducing stress on the tendon.
Strengthening: Strengthening exercises, especially eccentric loading, enhance tendon resilience, promoting healing and preventing future injury.
Correcting Biomechanics: Gait analysis and corrective exercises can address biomechanical issues, such as overpronation or weakness in the kinetic chain.
Education: Physical therapists provide guidance on activity modifications, proper footwear, and strategies to prevent re-injury.
Treatment Strategies to Reduce Pain
Eccentric Strengthening Exercises: Eccentric loading of the Achilles tendon has been shown to be highly effective in reducing pain and promoting tendon healing. Exercises like eccentric calf raises. We will also look at the hip, core, walking mechanics, and
Stretching: Gentle stretching of the calf muscles helps alleviate tension on the Achilles tendon. The runner's stretch (gastrocnemius and soleus stretches) can improve flexibility. Incorporating foam rolling can also release tightness in the calf muscles.
Manual Therapy: Soft tissue mobilization, deep tissue massage, and myofascial release can reduce tension and adhesions around the tendon, promoting blood flow and healing.
Dry needling: dry needling can be an effective strategy to reduce pain and improve flexibility of those the tendons. Dry needling works well when there are deeper trigger points manual therapy isn’t able to mobilize or release.
Modalities: Iontophoresis and laser therapy (available at our Franklin location) can help decrease inflammation and pain. Taping techniques like kinesiology taping can also support the tendon and reduce pain during activities.
Activity Modification: In the high inflammation phase, avoid aggravating loading activities, such as running or jumping, while incorporating low-impact exercises (e.g., cycling or swimming) can aid in recovery without stressing the tendon. Physical therapy can teach correct mechanics of jumping, hopping, and running to decrease pain.
Footwear and Orthotics: Proper footwear with adequate arch support and cushioning can reduce stress on the Achilles tendon, and the other tendons that support the arch. Custom orthotics may be recommended for those with biomechanical issues such as overpronation (flat foot) which puts an increased stress on the tendon.
Progressive Loading: Gradually reintroducing weight-bearing and plyometric activities can help the tendon adapt and strengthen over time. This progression should be done carefully under the guidance of one of our physical therapists. Achilles tendon pain can take 12 weeks to see significant improvement based on tissue healing the sports of activities you enjoy.
Physical therapy offers a comprehensive and tailored approach to treating Achilles tendonitis, depending if the origin is coming from another muscle group higher, or weakness or tightness of the calf muscles. Being patient with strengthening is key due to the healing time of the tissues.
