Achilles Tendinopathy Causes

Achilles Tendinopathy Causes

Achilles tendinopathy is a painful and debilitating condition. However, this injury can be healed with the right program. This article contains everything necessary for you to learn about this condition, its symptoms and how to repair the damage. Many who undergo this program enjoy a full recovery and can return to normal exercise and sports

Different Factors, Which May Cause Achilles Tendinopathy

Achilles tendinopathy can affect anyone. Those who suffer from it usually go running a lot or play sports that involve running, such as volleyball, badminton, tennis and football. Both men and women of all ages can suffer from achilles tendinopathy.

Achilles tendinopathy causes are not clear, but it starts when the achilles tendon is under strain, and the tendon doesn’t adapt to it well. This condition causes damage to the individual fibers of the tendon. The tendon naturally tries to repair itself; this is one of the components that leads to the resultant problem.

There seem to be some indicators as to why specific people are more prone to this ailment than others. Those who have it usually fall into one of the categories below.

Age: It usually affects people in the age range of 45 to 65

Gender: More males have achilles tendinopathy than females

Weight: Overweight and obese individuals are the usual victims

Diabetics: Those who have this ailment are often diabetic

Those who have extremely firm muscles in the calf, as well as those who have weak muscles, are more susceptible to this ailment.

Having weak legs also makes it easier for this condition to develop.

Having poor core muscles in the hip as well as damaged or weak knees are also thought to be achilles tendinopathy causes.

When the joints in the foot are stiff, there is greater chance of suffering from achilles tendinopathy.

Activities That May Cause Achilles Tendinopathy

These are some common practices, training habits, and problems that were precursors for some who developed achilles tendinopathy.

  • Running an extremely long distance
  • Running too fast
  • Running long distances too early in your training
  • Repeatedly doing a training routine, without alternating exercises
  • Wearing the wrong shoes
  • Excessive running on hills

Some useful training tips to improve your chances of avoiding achilles tendinopathy or making it worse are included here.

The Name

This condition was originally named achillis tendinitis. It was given this name because doctors believed it was inflammation in the achilles that created the condition, and “itis” means inflamed. It was recently discovered that it wasn’t inflammation that was causing this condition but rather degeneration or damage to the fibers in the achilles. The changes in the tendon, which can be seen under a microscope, led the doctors to call this condition tendinopathy or tendinosis.

Detection

Achilles tendinopathy can be detected quickly and safely through imaging, such as an ultrasound. An MRI has been used at times too, but this isn’t as easily accessible, and it is a more timely procedure. Most commonly, this condition is detected through clinical findings rather than imaging.

Common Symptoms of Achilles Tendinopathy

1. Stiffness in the morning:

Patients will often notice stiffness in and around the achilles when they wake up. The stiffness usually subsides after a few minutes of walking around.

2. A tender achilles tendon:

At times, this tendon will hurt a bit when lightly squeezed or when any pressure is applied to it. You may also feel a tender lump in the area, or there might be a clicking sound when moving the ankle around.

3. Pain level

Sometimes, you will feel fine enough to exercise, train or play while in pain, and it will ease up or even disappear upon activity but hurt even more afterward. At other times, it may be too unbearable to carry out any such activities.

Pain Relief Methods

Ice: You can get instant relief from achilles pain by applying a modern cold compress to the area for 20 minutes. This is often done after activities or throughout the day up to 4 times.

Pain Killers: Pain killers, such as paracetamol have been known to be effective to relieve pain. Anti-inflammatories, such as diclofenac or ibuprofen work too.

Stretching: Stretch your calves regularly. Some appropriate stretches will be described later on.

Be Gentle With It

You can still remain active and fit without putting stress on the tendon. Exercises, such as cycling, water running and swimming are good choices.

Achilles Tendinopathy Treatment

Eccentric Exercise Program: This is the treatment and rehabilitation program for Achilles tendinopathy. The exercises will lengthen and strengthen the calf muscles. This conditions the calf muscles so that your achilles has as much relief and support as possible.

With the Eccentric Exercise Program, it will take from three to six months to experience significant relief from achilles tendinopathy pain. Sometimes, it takes even less than three months. About 70% of the time, people can gradually begin to resume regular activities after three months.

At some point during the Eccentric Exercise Program, you may notice an increase in pain; this is temporary and will subside upon your continuance of the exercises.

Signs of Improvement

The first thing you will probably notice is that your achilles tendon is less stiff in the mornings. Overall pain and tenderness in the tendon take the longest to disappear; usually up to three months.

During this program, you should most definitely expect to experience some pain when beginning each new exercise. Work out a 0 to 10 scale where 0 is no pain and 10 is unbearable pain. However, if the pain level goes past 4, then you should not continue.

The Gold Standard

This program is the gold standard for treatment of this condition. However, an estimated 10 to 30% will not respond well to it. In such cases, you are advised to seek assistance from Oxsport@noc.com. You will be reviewed and an alternative form of treatment will be suggested. A physiotherapist may suggest further treatment to help you progress more quickly.

Things to Remember:

Many experience pain when first starting this program, but this is normal, and the pain should subside.

If your perceived pain goes beyond a 4, then decrease repetitions or turn to some of the pain relief methods described earlier. Once the pain level goes below 4, then you can carry on with the program.

Even if you don’t notice its benefits right off, this program should be done regularly for at least 12 weeks. You will notice its benefits.

The first symptom to disappear is usually that stiffness in your achilles that you felt in the mornings, and tenderness will subside eventually.

If morning stiffness and other achilles tendinopathy symptoms become worse than they were before you started the exercise, then you need to reduce repetitions until it subsides. If reducing repetitions don’t help, then rest.

Stretches

Before beginning the exercises, it is quite essential that you stretch. The images will guide you through the stretches and the exercises.

1.Stretch The Left Soleus Muscle:

Hold stretch for 1 minute.
In the correct position, the stretch should be in the back calf muscle in the left leg. Do not let the heel of your left foot come off the ground for the duration of the stretch.

2. Stretch The Right Gastrocnemius Muscle:

Hold this stretch for 1 minute.

If your form is correct, you’ll feel this stretch at the back calf muscle in your right leg. Do not let your right heel come off the ground for the duration of the stretch.

Switch leg positions to stretch the right soleus and the left gastrocnemius.

The Eccentric Program

Exercise 1

Part 1:
Stand adjacent to a wall or use a sturdy bar for support. With legs straight and most of your body weight on your uninjured leg, raise up on to your tiptoes. Then, allow your injured leg to take most of your body weight, and lower your feet to the ground. Work up to doing 3 sets of 15 reps, two times a day.
Part 2:
Stand in front of a wall or sturdy bar for support. From a standing position, with your legs bent and most of your weight on your uninjured leg, raise up on to your tiptoes, then shift your weight to your injured leg and lower yourself down. Work up to doing 3 sets of 15 reps each, two times a day.
When these exercises start to get easier, move on to exercise 2.

Exercise 2

Part 1:
Stand in front of a wall or sturdy bar for support. Standing on both feet, while supporting most of your body weight with your uninjured leg, raise up on to your tiptoes. Shift your weight to your injured leg, lift your other foot off the ground completely, and lower the heel of your injured leg to the ground. Work up to doing 3 sets of 15 reps, two times a day.
Part 2:
Stand in front of a wall or sturdy bar for support. Standing on both feet with your legs bent, shift most of your body weight to your uninjured leg and raise up on to your tiptoes. Shift your weight to your injured leg, lift your other leg off the floor, and lower the heel of your injured leg to the ground. Work up to doing 3 sets of 15 reps, two times a day.
When these exercises start to get easy, move on to exercise 3.

Exercise 3

Part 1:
With a rail, wall or chair on at least one side for support, stand with balls of both feet on the edge of the bottom step or a stepper, legs straight. Shift most of your body weight to your injured leg, lift your other leg off the step, and lower your injured foot slowly until the heel is below the ball of the foot. Work up to doing 3 sets of 15 reps, two times a day.
Part 2:
With a rail, wall or chair on at least one side for support, stand with balls of both feet on the edge of the bottom step or a stepper, legs bent. Shift most of your body weight to your injured leg, lift your other leg off the step, and lower your injured foot slowly until the heel is below the ball of the foot. Work up to doing 3 sets of 15 reps, two times a day.
To increase the intensity of these exercises, wear a backpack filled with books while doing the exercises.

FAQs

Q. What is the eccentric exercise program?
A. There are two types of muscle contractions- concentric and eccentric. With concentric exercises, the muscle is shortened, and with eccentric exercises, the muscle is lengthened. Take bicep curls for instance. When you bend your elbow and lift the weight up, this is called a concentric muscle contraction, and when you straighten your arm to lower the weight, this is called an eccentric muscle contraction. So when you raise yourself up on to your tiptoes you are doing a concentric muscle contraction, and when you lower your heels back down, you are doing an eccentric muscle contraction.

Q. Is it possible for my tendon to rupture during these exercises?
A. You are not in danger of rupturing your tendon while doing these exercises.

Q. Will I be able to resume my regular activities and sports?
A. If the eccentric exercise program works for you, then you will be able to enjoy regular activities and sports again without any pain.

Q. When can I resume regular activities and sports?
A. When you can resume these activities depends on how bad your tendinopathy was and what activities you do. You should gradually resume such activities and increase the length and intensity in the same way. Remember that training errors, bad shoes and overexertion are possible causes of this ailment.

Q. Is it better to get surgery instead of doing the eccentric program?
A. Surgery should be a last resort only after all other avenues have been explored. Also, there is no guarantee that it will relieve you of pain.

Q. Will a steroid injection help me?
A. A steroid injection puts you at risk for a tendon rupture. Also, steroids help injuries where there is inflammation, and with achilles tendinopathy there is no such issue.

Helpful Tips

Increase running distance or time by no more than 10% each week.

Renew your training shoes every 300 to 500 miles. It’s always wise to have a spare pair of good trainers available.

Vary your training by alternating speeds, distances and times. This will help condition the tendon.

Refer to reputable websites for advice on exercise and sports training tips. Alternate running with cross training to give your body some relief.

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