There seems to be something in the water, I have seen a lot of these recently….heres some info to hopefully avoid achilles tendinopathy. Prevention is better than cure!
The Achilles is the longest and strongest tendon in the body and is subjected to vast loads during running. It has an elastic property which allows it to store energy as we land, the tendon then uses this stored elastic energy for propulsion. The Achilles tendon attaches the calf musculature to the heel bone and is made up a something called Collagen, this is thick strong fibrous tissue and in the Achilles tendon the fibres are bundled together like tightly packed spaghetti. Sometimes the Achilles can become painful, this usually occurs because the tendon cannot deal with excessive loads and starts to break down in an effort to repair itself. This process is largely non inflammatory, despite the condition previously being known as tendinitis indicating inflammation at the tendon. Commonly this occurs in runners because they have done one of two things:
- Tried to increase their training load too quickly
- Or they have had a long layoff from running and not graded their return to training. Too much too soon. Desperately trying to get fit in two weeks…ring any bells?! We have all been there.
Sometimes the tendon can be subject to overload due to biomechanical factors such as over pronation, excessive forefoot running, and too much running in minimalist footwear or carbon plated shoes.
Common symptoms are pain, stiffness, and sometimes a swelling or thickening around the tendon. This occurs as the tendon substance starts to change. When tendinopathy sets in the fibres become more spread out (looser spaghetti!) with other substances that should not be there and the tendon thickens. Very often the condition is worse after periods of immobility (first thing in the morning usually the worst), though can improve and “warm up” through the day, or through a run.
Caught early and with the right treatment/ adaptation of training the condition can be improved significantly in a matter of days: So top tips:
- Always maintain load through tendons in the off season with light exercise/ jogging
- Try to add speed-work into the training program incrementally and maintain the progression
- Avoid programs that involve too many “peaks and troughs” of speed-work and heavy milage
- Avoid over training in spikes/ minimalist footwear like racers or carbon plate footwear, these are best for speed-work/ tempo work really.
- If you think you have got it, get it checked out early! We have the ability to scan in clinic with high resolution ultrasound which helps to establish the degree of tendinopathy and guide further treatment. Most of the ones I see require an adaptation of training and minimal “treatment” in order to improve symptoms.
- If treatment is required we have numerous options in clinic including; Shockwave therapy, Laser therapy, and even Ultrasound guided injection therapy when required.
If you have any questions dont hesitate to get in touch and most of all dont keep training on that painful tendon without it being checked out!