Achilles Tendinopathy

The Achilles tendon is prone to overuse, especially in runners, jumpers and football codes. As the tendon ages, it dries out and is prone to degenerative change and scarring. This leads to weakening of the tendon and further injury.

“Tendinopathy” refers to a non-inflammatory degenerative change that occurs in tendons, near their attachment to bone. It is a result of “overuse”, complicating risk factors relating to you and/or the activities you have been involved in. If you have been playing sport, involving the upper body, it is likely this is a factor too.

The outcome is that the tendon has weakened, making it more prone to further injury. This viscous cycle needs to be broken, by preventing injury, addressing the factors that are contributing to the problem and working on strengthening the affected tendon.

The Achilles tendon is the terminal part of the calf muscles, and joins the heal bone at the back of the ankle. Large forces are transmitted via the tendon as the body is propelled forward.

What treatments have been shown may improve this condition?

1. Reduce the pain of tendinopathy
   
   • Local treatment such as ice massage
     
   • Paracetamol
   
   
2. Reduce the load on the tendon to help with healing
   
   • Relative rest: Modify activities (cease or reduce)
   
   
3. Assist the healing process
   
   • Nitrate patch: 1/4 of a "Nitrodur" placed on tendor spot and changed after 24 hours. May experience headache and/or dizziness.
   
   
4. Strengthen Achilles tendon
   
   • Eccentric loading program: This is a muscle tendon loading program that involves loading the tendon as it lengthens. It is a 12 week program of 3 sessions a day, 3 sets per session. There is an increase in intensity and repetitions at regular intervals.