Are you a runner or gym goer with pain in the back of the leg or heel?
The 4 stages of Achilles Rehabilitation
In the world of sports medicine, the term “Tendinopathy” is used to describe changes within the structural makeup of the tendon. They are usually the result of the tendon being unable to cope with an increase in loading or stress placed on it. One body area where we commonly see Tendinopathy is the Achilles.
Runners have an increased risk (approx 30 times) of developing Achilles tendinopathy but it is also common these days in other activities such as crossfit, F45 and other high intensity interval training modalities. Rapid increases in training load (such as running) is a major factor in developing Achilles tendinopathy however there can be other underlying factors as well which makes a thorough assessment from a physiotherapist vital. If you have pain in the Achilles region during or after running or training it is important to get your problem assessed and start your rehabilitation. The degree of dysfunction in the structure of the tendon can start off mild but if left unmanaged the structure of the tendon can become damaged to the point where the tendon is at risk of rupture or at least permanent damage.
Rehabilitation of Achilles tendon injuries can broadly be divided into 4 stages as seen in the graphic. Initially the focus is on pain relief (which usually also means a reduction in loading on the tendon and even some rest). Rehabilitation then focuses on specific exercises done in a progressive manner that attempt to restore the original structure and function of the tendon. Put simply, once pain is settled, we then need to focus on restoring the ability of the tendon to act more like a spring, with good strength and energy storage capability.
The issue we see too often, is that rehab programs are stopped too soon, shortly after the pain has gone and a short course of strength exercises is done. Without a complete rehabilitation program with progression through all 4 stages, it is likely that your Achilles pain will return in the future, and next time it could be worse. Don’t let this be you