Achillies Pain

Achilles Tendon Injury
Pain in the region of the Achilles tendon is an extremely common injury especially among distance runners. Injury to the Achilles tendon occurs when the load applied to the tendon, either in a single episode or, more often, over a period of time exceeds the ability of the tendon to endure that load. This is called Achilles tendinopathy. Factors that may predispose to Achilles tendon injury include:

 Years of running
 Increase in activity (mileage, speed, gradient)
 Decrease in recovery time between training sessions
 Change of surface
 Change of footwear
 Flat footedness
 Calf weakness
 Reduced muscle length (tight calves)
 Reduced range of movement at the ankle joints and joints of the foot

The keys to successful treatment of Achilles tendinopathy are early diagnosis and RICE (rest, ice, compression and elevation). Manchester Physio provide specific strengthening programmes and correction of predisposing factors such as muscle tightness and abnormal biomechanics. These are all required together with appropriate progression to functional activities and sport-specific rehabilitation programmes.

Achilles teninopathy responds best if treatment is implemented at an early stage with the aim being to settle pain and inflammation through the use of heel raises in shoes, soft tissue massage and mobilization of the Achilles tendon. Your physiotherapist will implement intensive self stretching programmes which are important to maintain muscle and tendon length.

Sever's Disease
Tendon attachments are cartilaginous plates that provide a relatively weak cartilaginous attachment from tendon to bone. In adolescents, during rapid growth phases, bone lengthens before muscles and tendons are able to stretch correspondingly. This can lead to traction of the Achilles tendon causing inflammation at the attachment of this tendon.

Posterior Impingement Syndrome
This is where the rear aspect of one of the bones of the ankle joint becomes pinched by the adjacent aspect of the shin bone when fully pointing the toes or during activities involving jumping and pushing off the toes such as ballet, gymnastics and football. This condition causes pain and tenderness at the back of the ankle. Treatment involves relative rest and manual mobilization of the joints of the foot and ankle. Occasionally surgical intervention is required.