Why Your Achilles Pain Won’t Go Away — And How to Finally Fix It
The achilles tendon is the largest and strongest tendon in the human body. It can support immense load, sometimes as much as 12.5 times a person’s body weight while in the act of running! Its main function is to force the foot into plantar flexion, pointing the toes down.
As with all tendons, irritation stems from primarily overuse due to frictional properties associated with repetitive cycles of dorsiflexing and plantarflexing the foot. When the irritation first begins in its acute phase, there is some mild inflammation associated and as such, icing should be beneficial following activity. However, as the load and continued use occurs, inflammation is no longer a part of the equation and what was previously called “tendonitis” we now call “tendonopathy”.
Tendonopathy is a term associated with soft tissue disorganized healing and is best visualized as knotted and adhered scar tissue. This disorganized and dysfunctional collagen healing leads towards limitation in joint range of motion, tightness, and a decrease in blood flow at the site.
Patients typically complain of pain and tenderness around the heel that intensifies with activity such as walking or running. There is usually difficulty standing on their toes or going down the stairs. The pain is more pronounced following periods of inactivity such as in the morning following sleep or after sitting for long stretches.
Achilles tendonitis usually develops from multiple points of failure in the muscular kinetic chain, including hip weakness, foot hyperpronation and weakness of the foot intrinsics and while these deficits will eventually need to be worked out, during the onset of treatment it is necessary to calm the symptoms down first.
Foam rolling through the calf and addressing the outer, middle and inside aspects of the calf as well as rolling through the hamstrings and glutes are excellent places to begin breaking up the adhesions in the soft tissue. Even though I am a heavy proponent of minimalist, low to no heel to toe drop shoes, it might be necessary to move into a 6 or 9mm drop shoe while rehabbing achilles tendonitis.
Patients receiving conservative care are shown to improve significantly more than those treating the condition with rest, ice and medication alone.
At Optimal Performance Center we utilize a variety of techniques such as Active Release Techniques, Graston Technique, Functional Dry Needling and extremity adjusting as well as prescription of exercises to improve the condition. If you have been struggling with pain in your achilles, please reach out to our office and start moving and feeling well again!
