Injury To The Achilles Tendon

4 Kinds Of Injury To The Achilles Tendon

There are 4 kinds of injury to the Achilles tendon.  Those include:

1. Achilles tendonitis - usually from an acute injury to the Achilles tendon; inflammation is present
2. Achilles tendinopathy - a weakened abnormally structured tendon without inflammation; usually from a chronic overuse injury to the Achilles tendon
3. Achilles Tear - a partial tear of the Achilles tendon, but it's still intact
4. Achilles Rupture - the Achilles tendon is torn completely resulting in a massive loss of function

Of these, Achilles tendinopathy is by far the most common type of injury to the Achilles tendon.

I've done another post about the difference between Achilles Tendonitis, Achilles Tear, and Achilles Rupture so I'll refer you to that post for those types of injuries.

This post will be dedicated to Achilles Tendinopathy.

Specifically, I'll cover:

• What causes an overuse injury to the Achilles tendon?
• Treatment for Achilles tendinopathy
• Aerobic exercises for Achilles tendinopathy
• Eccentric strengthening exercise
• Calf stretches - good or bad?
• Self massage for an injury to the Achilles tendon

 

What Causes An Overuse Injury To The Achilles Tendon?

Achilles tendinopathy is an overuse injury to the Achilles tendon caused by the repetitive stress of the tendon with poor or improper recovery.

• Some things that can cause Achilles tendinopathy include:
  Poor or improper running technique
• Overtraining
• Poorly fitting shoes or lack of arch support
• Poor nutrition

Local Energy Crisis In Achilles Tendinopathy

When you have an overuse injury to your Achilles tendon, the number of mitochondria (energy producing parts of your cells) decreases.

The mitochondria use oxygen to turn glucose (sugar) from food into energy (ATP).

As a result, your muscle becomes less efficient at producing energy when you walk, run, jump, or do other activities.

Now, there is another way to produce energy, but it's not nearly as efficient!

• When you produce energy with oxygen, every molecule of glucose produces 32 ATP (energy units)
• When you produce energy WITHOUT oxygen, every molecule of glucose only produces 2 ATP.

Additionally, one of the bi-products of producing energy WITHOUT oxygen is lactic acid.

Lactic acid is the chemical that makes you "feel the burn" when working out.

It also prevents your muscles from contracting when it accumulates in your tissues.

Take home point... An overuse injury to your Achilles tendon can cause increased pain and decreased performance.

But you probably already knew that, right?

After all, that's probably why you're reading this page...

Because your Achilles tendon hurts and it's keeping you from doing the things you want to do.

... and you probably want to know what to do about it.

Treatment For An Overuse Injury To The Achilles Tendon

If you're overtraining, you'd think that that the "rest is best" mantra might apply, right?

After all, if TOO MUCH activity causes the problem, then resting from activity should be the solution, right?

Well, kind of. 

"Relative Rest" Is Best

While it's true that you want to rest from excessive activity, NO activity isn't good either.

When you rest completely, you don't get the blood flow and oxygen to your muscles that they need to produce energy as noted above.

So how do you increase blood flow to your calves and Achilles tendon? 

Aerobic Exercise For An Injury To The Achilles Tendon

General aerobic exercise such as walking, exercise biking, or swimming help increase overall circulation.

If you've got a really irritable case of Achilles tendinopathy you should probably skip high impact exercises such as running for a short period of time.

If your symptoms aren't as severe, you can get away with running with an Achilles tendon injury.  You just need to limit your distance to what you can do without having increased pain after running.

Eccentric Exercise An Injury To The Achilles Tendon

High-repetition heel raises also increase circulation to the Achilles tendon and can help with tissue repair.

Eccentric exercise means lowering a weight.

In this case, that means is doing a heel raise on 2 legs, and then coming down on 1 leg slowly.

Research shows that eccentric exercise is highly effective for Achilles tendinopathy.

Early studies used the "Alfredson protocol" of 3 sets of 15 reps with both knees straight and knees bent, twice per day.

That's a lot of exercise though if you have a painful Achilles tendon!

Newer research has shown that an "as tolerated" protocol works just as well as the Alfredson protocol - meaning you only do as many reps as you can tolerate.

While eccentric heel raises are a great exercise for Achilles tendinopathy, many people do heel raises incorrectly!

Learn how to do heel raises correctly

Calf Stretches For An Injury To The Achilles Tendon

Stretching your calves is sometimes good for an Achilles tendon problem.

If your calves are stiff, the Achilles tendon has to take up more of the impact force when running or jumping.

However, when you stretch your calves, you often stretch the Achilles tendon too.

If the Achilles tendon is overstretched or torn, you DON'T want to stretch it even further.

Making some modifications to HOW you stretch your calves can help.

Even if you make these changes though, you may also want to release the trigger points in your calves before stretching. Releasing the trigger points, or "knots" in your calf muscles can help relieve pain and make the calves more flexible.

Physical therapy techniques such as manual trigger point therapy or dry needling can make the calves more flexible so that you can stretch your calves more WITHOUT overstretching your Achilles tendon.