Achilles tendonitis … if you have suffered from it you know how much it can limit you with everyday life activity. The actual diagnosis is now termed ‘tendinopathy’ rather than tendonitis as recent evidence has found there is not an actual inflammatory process within the tendon. Regardless of the name, it refers to pain located usually up to 5cm up from the back of the heel. There are several different types of Achilles tendinopathy so if you suspect you have this problem it is a good idea to get a physiotherapist to confirm the diagnosis and type of presenting problem.
The good news is simple inexpensive treatment is available and quite effective in getting you active again. We commonly recommend 3 strategies that help:
- Despite the lack of bleeding or inflammatory cells present in a tendinopathy, applying ice safely to the local area still does provide benefit to many people. Simple things can be beneficial even if the understanding of why isn’t so simple. Put simply the benefit of ice is to reduce pain which assists beneficial exercise to be undertaken.
- Relative rest is also advised when managing tendon pain. This doesn’t mean complete rest from the aggravating activity but usually a reduction in the task that aggravates the pain.
- Active exercise based rehabilitation is the key to regaining strength and reducing pain with everyday life and exercise. This involves gentle and progressive loading exercises for your Achilles’ tendon known as the Alfredson protocol. The exercise is a type of eccentric exercise that is optimally performed with knees straight and knees bent and involves 3 sets of 15 repetitions of each. There may be soreness or pain that can last for a day, but the soreness should reduce as you progress the exercises over the course of weeks. Working with your physio will guide how much soreness is OK and when the protocol should be modified.
- To compliment these 3 treatments we also provide stability exercises for the core and legs muscles to compliment the Achilles exercises. For example, a lack of strength at the hip can increase the requirements and load on the calf and Achilles region. A more comprehensive and effective program will find any such imbalances and help if the goal is regular or more intensive exercise. To learn more, read our What is Eccentric Exercise? article.
If you have an achilles problem, start with a physio assessment and ask if the Alfredson protocol is appropriate for you.