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What is the achilles tendon?

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Achilles Tendinopathy.

What is the achilles tendon?

The Achilles tendon is found at the back of the ankle attaching to the heel bone (calcaneus bone) and is an extension of the calf muscles (gastrocnemius and soleus muscles). The Achilles tendon attaches the calf muscles to the foot and it’s elastic properties add to one’s ability to “push off” during walking and running. Philip Verheyen was the first to name the Achilles tendon after the Free hero Achilles in 1693, prior to that it was known as “tendo magnus of Hippocrates” (what a mouthful) (1).

What is Achilles Tendinopathy?
Overuse injuries of the Achilles tendon can be categorised as either insertional or non-insertional meaning at the attachment of the Achilles tendon and the heel bone or at the midway point of the Achilles tendon.

Mid-portion Achilles Tendinopathy: patients often report impaired performance and a combination of pain with nodular swelling roughly 2-7cm above the heel bone. The swelling can be diffuse (all around or along the tendon) or localised to a specific spot (2).

Insertional Achilles Tendinopathy: patients complain of pain, stiffness and sometimes a “solid swelling” located at the bone-tendon junction. Sometimes a bony spur may be palpable.

Who gets Achilles Tendinitis?
Pain in the Achilles tendon is relatively common in recreational exercisers, individuals active in sports and has even been reported in inactive individuals (3).

What are the treatment options for Achilles Tendinitis?
Treatment options for Achilles Tendinitis includes activity modification, orthotics, massage, dry needling, strengthening exercises and ultrasound.

Corticosteroids are a class of medications that are related to a steroid called cortisone. They relieve pain by reducing the inflammation that occurs in a diseased tendon. There have been many conflicting studies regarding the use of corticosteroid injections in Achilles tendinopathy since there is no inflammatory process. (4)

At our IceFire Physiotherapy clinic in Brendale we have had the opportunity of helping people with both Insertional and Mid-portion Achilles Tendinopathy from many of the surrounding suburbs, including, North Lakes, Warner, Strathpine, and Eatons Hill. Treatment over the course of weeks is often successful. So the goods news is that Achilles pain can go away; it can resolve.

References
Van Dijk, C. N., Van Sterkenburg, M. N., Wiegerinck, J. I., Karlsson, J., & Maffulli, N. (2011). Terminology for Achilles tendon related disorders.

Zwiers, R., Wiegerinck, J. I., & Van Dijk, C. N. (2016). Treatment of mid portion Achilles tendinopathy: an evidenced-based overview. Knee Surgery, Sports Traumatology, Arthroscopy, 24(7), 2103-2111.

Alfredson, H., & Cook, J. (2007). A treatment algorithm for managing achilles tendinopathy: new treatment options. British Journal of Sports Medicine, 41(4), 211-214.

Lopez, R. G., & Jung, H. (2015). Achilles Tendinosis: Treatment Options. Clinics in Orthopedic Surgery, 7(1), 1. doi:10.4055/cios.2015.7.1.1

Kind Regards,
Jonathan Clerke

Principal Physiotherapist
IceFire Physiotherapy, Brendale (near the suburbs of Eatons Hill, Warner,Albany Creek, Carseldine, Strathpine and Bald Hills)
31.10.2018

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