Achilles tendon disorders are common in athletic and non-athletic populations. Approximately 24% of competitive athletes will experience an Achilles tendon disorder during their lifetime (with 18% sustained during their sporting career). Among runners, the prevalence is much higher (40-50%) [1].
The Achilles tendon connects the calf muscle (gastrocnemius) to the back of the heel (calcaneus).
- Achilles tendon disorders are characterised by pain in the mid-portion of the tendon (above where it connects to the heel).
- Pain is typically aggravated by movements that involve the calf muscle, such as jumping and landing, running, and heel raises.
The strongest risk factors for Achilles tendon disorders include [2]:
- Decreased calf muscle strength
- Previous Achilles tendon injury
- Sudden increase in training load
Factors that do not increase the risk of Achilles tendon disorders include:
- Being overweight or obese
- Having flat feet
How Can Physiotherapy Help?
A structured exercise program is strongly recommended for Achilles tendon disorders [3]. These programs are typically delivered by a physiotherapist, as they have the necessary expertise and skills to develop, monitor and progress the exercise program.
The exact exercise program will depend on the patient’s previous activity levels and return to sport/activity goals. Exercise programs may include:
- Progressing from double leg heel raises, to single leg heel raises, to elevated single leg heel raises on a step
- Decreasing running mileage and gradually increasing mileage again throughout the program
References:
[1] NCBI: Cumulative incidence of achilles tendon rupture and tendinopathy in male former elite athletes.
[2] British Journal of Sports Medicine Vol 53, Issue 21: Clinical risk factors for Achilles tendinopathy: a systematic review
[3] Journal of Orthopaedic & Sports Physical Therapy: Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision
2018