Achilles Tendonitis Pain Treatment Birmingham
One of the most common sporting lower limb injuries we see on our clinic is Achilles pain. The Achilles Tendon is particularly susceptible to damage for runners and people who have active jobs, it can be a difficult area to treat.
What is a Tendinopathy?
We prefer the term tendinopathy rather than tendonitis, these can occur in any structure in the lower limb. For example runners might suffer patella tendinopathy (knee pain), posterior tibial tendinopathy (along the inside of the arch) or peroneal tendinopathy (outside of the ankle) to name but a few. If you think of the human body as a building site which is constantly building new tissue (synthesis) or breaking its tissue down. The amount of tissue breakdown is dependent upon how much load we place on these tissues.
If we load a tendon such as the Achilles tendon too much or too quickly the amount of tissue break down is quicker than tissue building, this would be a very bad building site! This leads to pain and a vicious catch 22 cycle. A classic running scenario is doing too much, too soon. A rapid increase in mileage doesn’t allow the tendon time to adapt to deal with the load and as a result it starts to breakdown. Hill work also places greater stress on the Achilles and doing too much can also cause this issue. Increasing speed, changing stride length and not having enough rest can also play a part.
We at Dr Foot Podiatry Clinic believe that patients should understand their injury as it leads to better understanding of why we treat your tendinopathy in a certain way. Tendinopathy is divided into stages, initially when you damage the Achilles tendon you are in a reactive stage. If we can go back to the analogy of the building site, this is when the body realises too much tissue has been broken down due to an increase of loading so the body sends workers to fix the Achilles tendon. This would lead to swelling, pain and the Achilles tendon can thicken also. Most of the cases we see in clinic are either tendon dysrepair which follows reactive tendinopathy or degenerative tendinopathy.
Sounds like a bleak picture doesn’t it?! It needn’t be. If the problem is identified by one of our podiatrists and treated early it often fully resolves but it is something that needs acting on. It probably won’t go away on it’s own.
Patients usually describe a gradual onset of pain in the Achilles tendon during or after a run. The symptoms worsen and can become more frequent.
Pain or tenderness may be present around 2cm-5cm above the heel bone and can get worse when walking on toes, symptoms are often worse first thing in the morning.
What else could it be?
This is why diagnosis is key! We find patients who search Google and YouTube for solutions often cause more damage to the Achilles tendon. Often the site of the pain is the insertion of the Achilles into the heel bone, this is called insertional Achilles tendinopathy. This is treated completely differently to mid portion Achilles tendinopathy. Other possible conditions that are misdiagnosed as Achilles Tendinopathy are retrocalcaneal bursitis, calcaneal bursitis, Posterior Tibial Tendon Dysfunction (PTTD) and even plantar fasciitis.
What can we do for your pain?
If I may repeat the statement above, diagnosis is key! We will diagnose the type of Achilles tendinopathy or associated condition using ultrasound and clinical tests. We will also examine associated structures in the kinetic chain that may be the underlying cause of the Achilles tendon pain. We wish to address the Achilles tendinopathy but we also want to make sure that you don't get this condition again. If you are a runner then we will assess your running shoes and training regime so that you can work within "your zone of optimal stress". We will then provide a rehabilitation programme which is suitable for your particular Achilles tendinopathy, provide orthotics based on your biomechanical needs and may provide other treatments such as K-Tape, shock wave, laser, acupuncture and prolotherapy injections (not steroid injection as this could rupture the Achilles tendon).
We offer a variety of treatments to treat achilles pain such as Extracorporeal shockwave therapy for Achilles Pain, Low Level Laser Therapy, Custom Orthotics for Achilles Tendinopathy and Injection Therapy.