Achilles Tendinopathy Treatment: How Physiotherapy Helps Athletes Recover Faster
Achilles tendinopathy is a common condition that affects the Achilles tendon, which connects the calf muscles to the heel bone. Whether you're a runner, an athlete, or someone who enjoys walking, this condition can be painful and limit your mobility. In this blog, we’ll explore what Achilles tendinopathy is, how physiotherapy can help, and what steps you can take towards recovery.
What is Achilles Tendinopathy?
Achilles tendinopathy refers to damage or degeneration in the Achilles tendon. It typically occurs when the tendon is overloaded due to repetitive strain or overuse. There are two main types of Achilles tendinopathy: acute and degenerative. Both can cause discomfort, but they differ in their development and the way they affect the tendon.
Acute Achilles Tendinopathy: This is an early-stage injury where the tendon is inflamed but not yet degenerative. It often occurs suddenly after an increase in physical activity, such as running or jumping. The tendon may feel sore and swollen, especially in the morning or after exercise.
Degenerative Achilles Tendinopathy: Over time, if the tendon doesn’t heal properly, it may become degenerative. In this stage, the collagen fibers within the tendon start to break down, weakening the structure. This can lead to long-term discomfort and an increased risk of tendon rupture if not managed appropriately.
Acute on Degenerative Achilles Tendinopathy: This occurs when a sudden flare-up of inflammation happens on top of an already degenerative tendon. The combined effect of degeneration and acute inflammation can lead to more severe pain and disability.
What is the Best Treatment for Achilles Tendinopathy?
The treatment for Achilles tendinopathy varies depending on the severity and stage of the condition. However, there are some common approaches:
Rest and Activity Modification: One of the first steps in treating Achilles tendinopathy is to reduce or temporarily stop the activity that caused the strain. This gives the tendon time to heal and prevents further damage.
Eccentric Exercises: These are exercises that involve lengthening the muscle while it contracts, which is particularly effective for strengthening the Achilles tendon. Physiotherapists often recommend eccentric calf exercises as part of the treatment plan.
Physiotherapy: A physiotherapist can tailor a rehabilitation program to address the specific needs of your Achilles tendon. This may include exercises to improve strength, flexibility, and mobility, as well as manual therapy to reduce stiffness and pain.
Orthotics and Footwear: Supportive footwear or orthotics can help reduce strain on the tendon during daily activities. Custom-made inserts can correct biomechanical issues that may be contributing to the injury.
Can Physiotherapy Help Achilles Tendonitis?
Physiotherapy is one of the most effective treatments for both the early and chronic stages of Achilles tendinopathy. A physiotherapist will start by assessing your condition, taking into account factors like your activity levels, any biomechanical issues (e.g., poor foot posture or gait), and muscle imbalances that may be contributing to the problem. From there, they will create a tailored rehabilitation plan that includes specific exercises to target the Achilles tendon and surrounding muscles.
A key component of physiotherapy treatment is eccentric strengthening exercises, which help to rebuild the damaged tendon fibers, improve flexibility, and reduce pain. These exercises involve controlled lengthening of the muscle and tendon, typically by lowering your heel off a step. Over time, this helps to improve the tendon’s ability to withstand load and can significantly speed up recovery. In addition to exercise therapy, physiotherapists can use a variety of hands-on techniques such as manual therapy to help alleviate stiffness, deep tissue massage to break down scar tissue, or dry needling to target specific points of muscle tightness.
Another crucial part of physiotherapy is the education you’ll receive about injury prevention. This might include advice on proper footwear, correcting your running technique, or how to warm up and cool down effectively before and after exercise. Physiotherapists are trained to not only address the immediate symptoms of Achilles tendinopathy but also to help you avoid future injury by correcting underlying issues. By following their guidance and committing to a rehabilitation plan, many people experience significant improvement and can return to their normal activities pain-free.
Is It OK to Walk with Achilles Tendinopathy?
Walking with Achilles tendinopathy can be a balancing act between maintaining mobility and avoiding further damage. In the early stages of the injury (known as acute tendinopathy), it is often best to reduce or modify activities that put excessive strain on the tendon. High-impact movements like running, jumping, or even walking long distances may aggravate the condition, leading to increased pain, swelling, and potentially prolonging the recovery process. In these cases, it’s essential to give the tendon adequate time to rest and heal.
That said, walking is generally less strenuous on the Achilles tendon compared to activities like running, and it can be included as part of a carefully managed rehabilitation plan. Walking at a slow to moderate pace, especially with supportive footwear, can help maintain mobility and circulation without overloading the tendon. Physiotherapists often advise patients to listen to their bodies during this time; if walking causes significant pain or swelling, it may be necessary to further modify your activity levels or use assistive devices like crutches temporarily.
As your recovery progresses and your Achilles tendon becomes stronger through physiotherapy, walking can be gradually increased. Low-impact activities, including walking, may even serve as a tool to gently load the tendon, improving its capacity to handle stress over time. It’s important to work closely with a physiotherapist, who can provide guidance on when it’s safe to reintroduce walking into your routine and how to do so without risking re-injury. The goal is to restore your ability to walk comfortably and confidently without exacerbating the tendinopathy.
How Long Does It Take to Recover from Achilles Tendinopathy?
Recovery time for Achilles tendinopathy can vary significantly depending on the severity of the condition and how closely you adhere to a structured treatment plan. For mild cases, where the tendon is inflamed but not significantly damaged, recovery can take anywhere from 6 to 12 weeks. During this time, physiotherapy plays a key role in strengthening the tendon, reducing pain, and helping you regain normal function. Adhering to your rehabilitation exercises, modifying activities to avoid overloading the tendon, and making lifestyle adjustments are essential to a smooth recovery.
However, in cases of chronic or degenerative Achilles tendinopathy, where the tendon has undergone structural changes and collagen fibers have deteriorated, recovery can take much longer—often several months. Degenerative tendinopathy requires a more gradual and prolonged approach to allow the tendon to adapt to load over time. Physiotherapy during this stage will focus on rebuilding tendon strength through specific exercises and improving your biomechanics to prevent further damage.
Patience and consistency are critical to successful recovery. Rushing the process or returning to high-impact activities too soon can lead to setbacks or even a complete rupture of the Achilles tendon, which would require surgical intervention. It’s also important to note that each person’s recovery journey is different. Factors like age, overall health, activity level, and the duration of the injury all play a role in determining how quickly the tendon heals. By working closely with a physiotherapist, you’ll have a clear plan and timeline tailored to your condition, with regular adjustments based on your progress.
Conclusion
Achilles tendinopathy can be a frustrating and painful condition, but with the right treatment plan, including physiotherapy, recovery is possible. Understanding the differences between acute and degenerative tendinopathy, seeking early intervention, and following a structured rehabilitation program will help you get back to your activities with less pain and greater confidence.
If you're struggling with Achilles tendinopathy, don’t hesitate to reach out to a qualified physiotherapist who can guide you through your recovery journey.
Our articles are not designed to replace medical advice. If you have an injury or health concern, we recommend seeing a qualified health professional.
