There are many issues that can be the cause of Achilles pain eg. Achilles Tendinitis, Achilles Tendinosis and Achilles Rupture.
The Achilles tendon is at the base of the calf muscles at the back of your lower leg and is a structure that experiences a lot of stress and a very common point of pain.
Achilles rupture is a complete tear of this tendon. Some people feel they have been hit from behind in the lower leg and may experience a loud sound. It often requires surgery but can sometimes be managed conservatively in a boot. It is important to attend A&E if you experience a pop with immediate pain in the Achilles area at the back of the ankle.
Achilles Tendinitis is one of the most common reasons for Achilles pain.
Achilles Tendinitis is an overuse of the Achilles tendon. It is common in runners and in middle aged people who play sports, such as tennis or basketball. It usually develops gradually, and the pain is generally just above the heel at the back of the ankle. It can have swelling in the acute phases and can also present with a crunching feeling.
A normal non-sporting individual should be able to do 15-20 single leg calf raises (up on tippy toes) before fatigue on dominant and non-dominant sides.
This figure increases to 20-25 in casual runners and 30+ in trained/marathon runners.
Mary, a 52-year-old lady presented to the clinic with a 3-month history of Achilles pain on weightbearing. She experienced pain immediately when getting out of bed in the morning which generally subsided with a few steps. Mary walked 5km most days and complained about getting pain always at the start of her walk but that this went away after a couple of minutes.
Mary was very tight in her calf muscles and was getting pain on stretching of the calf.
Some of the things we explored with Mary were her activity levels, nutrition, hormonal changes and apparent wearing of any fat pads in the area. We looked at Marys training/walking schedule – looking at the terrain, footwear, equipment and looked at her walking pattern which meant looking at her hips and knees.
We started with removing the factors that were increasing her pain and began gradually loading the tendon. We also began a strengthening programme working on her calf strength and her hip strength. We addressed stiffness that was present in both of Mary’s ankles and began her gradual return to previous activity.
We saw Mary four times over the space of 6 weeks and her pain had cleared. Mary continued with a strengthening programme which has allowed her to return to her normal activities of daily living and pain free.
If you or anyone you know is experiencing heel/Achilles pain, please don’t hesitate to come in for an assessment at Laois Physiotherapy Clinic.
Laois Physiotherapy Clinic, The Coachhouse, 4 Kellyville Park, Portlaoise, Co. Laois. R32 NX59
Tel: 087 9945057
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