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Just like for the mythical Greek demigod, the Achilles Heel (or Tendon) can be the area of vulnerability for many of us mere mortals.
We recently had an in-service training session with Tendon Guru Ebonie Rio, whose research is revolutionising the management of lower limb tendinopathies. Here are some insights from the session, to assist with the treatment of this very prominent and notoriously difficult to treat injury.
Diagnosis is key.
The first point to get across is that the diagnosis of your Achilles pain is absolutely crucial to its management. This may seem like a very obvious start, but the reason a lot of these Achilles Tendinopathies persist is due to a wrong diagnosis at the start.
There are many things that can cause pain in the region of the Achilles, whether it’s the tendon itself, the sheath surrounding the tendon (the paratendon), the calf complex or even the lumbar spine, and all these issues are treated very differently. So if you have pain in the region of your Achilles, come down and see one of our Physiotherapists for an accurate diagnosis. We can set you on the right path to resolution.
Stop touching it!
Research shows that compression plays a huge role in not only the development of a tendinopathy but also its persistence and the progression of the pathology. So if your Achilles hurts, stop poking it and just point to the area that’s sore and let us do the rest. Also if anyone you’re seeing suggests doing frictions to your painful Achilles tendon… run / limp for the hills!
Avoid calf stretching.
We all like to “stretch out” things that are sore and tight, but your calf muscles become the Achilles tendon before it attaches onto your heel, so any stretch your put through your calf – you guessed it – goes through your Achilles.
Most Achilles Tendinopathies will have an area of the tendon that is swollen. This, however, isn’t swelling in the true sense. When you twist your ankle throwing shapes at the weekend, this swelling is within the tendon itself, so any stretch force will cause further compression to the area, and remember compression is bad! If you find your calves are tight, use our trusty old pal Mr. foam roller – but you mustn’t roll the actual tendon itself.
Instant pain relief.
Research has shown that doing a very specific type of exercise with a specific load can instantly reduce tendinopathic pain! “So, what do I have to do?!” we hear you ask. Well, because of the type of exercise and load being so specific it’s really important that you allow trained professionals to prescribe these exercises. If done incorrectly you may end up making your pain worse! So if you do have Achilles tendon pain, come and see the team at Pure Physio so that we can give you an accurate diagnosis and treatment plan that implements this new research. This is not a method of curing the tendinopathy, but what this does allow us to do is rehabilitate the tendon much more effectively by being able to address the pain component.
About the Author
Kate Senini — Consultant Physiotherapist
Kate was a founding partner at Pure Physio in 2010 after returning from working in the UK. Recently Kate has decided to focus exclusively on her clinical role. Helping people recover from injury and prevent future injuries has always been her true passion!