Achilles Tendinopathy is a common overuse injury of the Achilles tendon and a condition we treat ALOT in the clinic.
What is Tendinopathy?
The widely accepted Cook and Purdum model explains Tendinopathy in 3 stages:
1. Reactive tendinopathy: When compressive or tensile overloading takes place, the tendon thickens and stiffens in attempt to reduce the stress on the tendon.
2. Tendon disrepair: If the tendon is not offloaded and allowed to repair back to stage 1, the tendon cell matrix will start to separate and breakdown physiologically.
3. Degenerative tendinopathy: If the tendon is further overloaded, permanent damage of the cellular makeup will occur.
Tendon change occurs along this continuum and may go back and forth between these 3 stages.
How does overloading occur?
Overloading commonly occurs in the form of:
· Excessive loading through high impact activity such as running or jumping. The Achilles tendon may take loads of up to 2x your body weight when running.
· An increase in training load of high-impact activity or resistance training.
· A return to training after weight gain.
How can improve you improve your Achilles pain?
The key to moving back through the stages of tendon damage needs to follow 2 simple yet crucial steps.
1. UNLOAD – Give the tendon the rest it requires to move back down the stages of damage. This may not be complete rest, but instead a “relative” reduction in your activity e.g. reduce kilometres running by 20%
2. LOAD the tendon to prevent further disrepair. This step requires a careful gradual and progressive loading program which is tailored to the individual’s needs. Rehabilitation with a safe loading can begin straight away and reduces recovery time versus complete rest.