Achilles tendinosis is a common yet challenging condition affecting the Achilles tendon, the thick band of tissue connecting the calf muscles to the heel. Unlike Achilles tendinitis, which involves inflammation, Achilles tendinosis is characterized by chronic degeneration of the tendon fibers without significant inflammation. At Adaptive Physiotherapy & Massage in Booragoon, we offer evidence-based treatment approaches, manual therapy, and exercise rehabilitation to help patients effectively manage Achilles tendinosis, reduce pain, and restore function.
What is Achilles Tendinosis?
Achilles tendinosis is a degenerative condition resulting from overuse or repetitive stress on the Achilles tendon. Unlike tendinitis, which is an acute inflammatory condition, tendinosis involves long-term damage to the tendon structure, often accompanied by microscopic tears and collagen fiber disorganization. This degeneration leads to a weakened, less flexible tendon, which can cause pain, stiffness, and limited mobility.
Common symptoms of Achilles tendinosis include:
- Persistent pain and tenderness along the Achilles tendon, especially with activity
- Stiffness in the Achilles tendon, often felt most acutely in the morning or after prolonged rest
- Swelling or thickening of the tendon, sometimes with visible lumps along the affected area
- Decreased strength and limited range of motion in the ankle
Achilles tendinosis can affect both recreational and competitive athletes, as well as individuals with physically demanding jobs. Risk factors include inadequate footwear, abrupt increases in physical activity, poor calf flexibility, and biomechanical issues such as overpronation.
Evidence-Based Treatment for Achilles Tendinosis
At Adaptive Physiotherapy & Massage in Booragoon, our approach to treating Achilles tendinosis is based on current research, focusing on reducing pain, restoring function, and preventing recurrence. Given that Achilles tendinosis is a degenerative condition, treatment aims to promote tendon healing and strengthen the area to handle load more effectively.
1. Pain Management and Load Modification
A primary goal in treating Achilles tendinosis is to manage pain and modify load on the affected tendon. For individuals with acute pain, reducing or adjusting high-impact activities, such as running or jumping, may be necessary to allow the tendon to heal. Low-impact alternatives, such as cycling or swimming, can help maintain cardiovascular fitness while reducing strain on the Achilles.
In addition to activity modification, using supportive footwear and orthotics can help improve foot biomechanics and relieve stress on the tendon. Adaptive Physiotherapy & Massage offers guidance on footwear adjustments and may recommend orthotic devices to address underlying biomechanical issues, especially for patients with flat feet or high arches.
2. Pain and Inflammation Management
Although Achilles tendinosis is not primarily inflammatory, pain management techniques such as ice application and nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to alleviate discomfort in the early stages of treatment. However, these measures are temporary and do not address the degenerative nature of tendinosis. Adaptive Physiotherapy & Massage in Booragoon emphasizes a comprehensive approach that focuses on improving tendon structure and resilience.
Manual Therapy for Achilles Tendinosis
Manual therapy is a key component in the treatment of Achilles tendinosis at Adaptive Physiotherapy & Massage. Through targeted techniques, our physiotherapists help improve circulation, reduce muscle tension, and promote healing in the affected area.
1. Deep Friction Massage
Deep friction massage is a specific technique used to promote collagen alignment and reduce adhesions within the tendon. This technique involves applying controlled pressure across the tendon fibers, helping to stimulate blood flow and encourage tissue repair. Evidence shows that deep friction massage can improve pain and function in individuals with tendinosis, especially when combined with exercise rehabilitation.
2. Soft Tissue Release
Soft tissue release focuses on the calf muscles and surrounding connective tissues. Tight calf muscles, particularly the gastrocnemius and soleus, can increase strain on the Achilles tendon. Soft tissue release techniques, such as myofascial release and trigger point therapy, help alleviate muscle tightness, improving flexibility and reducing stress on the tendon.
3. Joint Mobilizations
Joint mobilizations target the ankle joint, enhancing range of motion and improving load distribution during movement. Limited ankle dorsiflexion (upward movement) can contribute to increased strain on the Achilles tendon, particularly during activities like running or jumping. By improving ankle mobility, joint mobilizations help reduce the risk of reinjury and improve overall function.
Exercise Rehabilitation for Achilles Tendinosis
Exercise rehabilitation is crucial for achieving long-term recovery and building resilience in the Achilles tendon. Adaptive Physiotherapy & Massage in Booragoon tailors exercise programs to each patient’s needs, focusing on strength, flexibility, and functional performance.
1. Eccentric Strengthening
Eccentric exercises are one of the most effective treatments for Achilles tendinosis. These exercises focus on lengthening the muscle while it is under tension, which has been shown to stimulate tendon remodeling and improve collagen alignment. The most commonly used exercise is the eccentric heel drop, where the patient stands on their toes and slowly lowers the heel below the step level. This exercise specifically targets the Achilles tendon, promoting tissue healing and reducing pain.
Patients typically perform eccentric strengthening exercises daily, gradually increasing resistance as they build strength and tolerance. Research supports the efficacy of eccentric training in reducing symptoms and preventing recurrence of Achilles tendinosis.
2. Calf Strengthening and Flexibility
In addition to eccentric exercises, strengthening the calf muscles and improving flexibility are essential components of rehabilitation. Strengthening exercises, such as calf raises and seated heel lifts, target both the gastrocnemius and soleus muscles. Improved calf strength reduces strain on the Achilles tendon, enhancing its capacity to handle load.
Stretching exercises targeting the calf muscles and Achilles tendon help increase flexibility, reducing the risk of further injury. Common stretches include the standing calf stretch and the wall stretch, both of which improve dorsiflexion and reduce stiffness in the Achilles tendon.
3. Proprioception and Balance Training
Proprioception and balance exercises help restore stability and control in the ankle joint. For individuals recovering from Achilles tendinosis, balance exercises such as single-leg stands, wobble board training, and dynamic movements can improve neuromuscular control and reduce the likelihood of reinjury.
At Adaptive Physiotherapy & Massage, we incorporate proprioception training into our programs to help patients regain confidence in their movement, particularly for those returning to sports or physically demanding activities.
Additional Considerations for Managing Achilles Tendinosis
Managing Achilles tendinosis effectively requires a multifaceted approach that includes lifestyle modifications, patient education, and preventive strategies.
Gradual Return to Activity
For individuals engaged in high-impact sports or physically demanding activities, it is essential to gradually reintroduce these activities once pain subsides. Our physiotherapists develop a structured return-to-sport plan that allows patients to rebuild strength and flexibility without overstressing the Achilles tendon. Monitoring progress and making adjustments as necessary are key to preventing setbacks.
Patient Education and Self-Management Strategies
Educating patients about the nature of Achilles tendinosis and providing strategies for self-care is a core part of treatment at Adaptive Physiotherapy & Massage in Booragoon. Our physiotherapists provide guidance on daily stretching routines, footwear choices, and proper warm-up and cool-down techniques. Empowering patients with knowledge about their condition reduces the risk of recurrence and supports long-term recovery.
Conclusion
Achilles tendinosis can be a painful and limiting condition, but with the right approach, most individuals can achieve substantial relief and regain function. At Adaptive Physiotherapy & Massage in Booragoon, our treatment approach combines evidence-based manual therapy, exercise rehabilitation, and personalized care to address the root causes of tendinosis and build tendon resilience. Through a comprehensive and tailored program, our physiotherapists help patients overcome Achilles tendinosis, reduce pain, and regain confidence in their physical activities.
If you’re experiencing persistent Achilles pain, reach out to Adaptive Physiotherapy & Massage in Booragoon. Our experienced physiotherapists are here to guide you through every stage of recovery, helping you return to the activities you love with improved strength and flexibility.
References
- Alfredson, H., et al. (2018). “Eccentric Training in Achilles Tendinosis: A Systematic Review.” Journal of Orthopaedic & Sports Physical Therapy.
- Khan, K. M., et al. (2020). “Current Concepts in Achilles Tendinosis: Evidence-Based Treatment and Rehabilitation.” British Journal of Sports Medicine.
- Munteanu, S. E., et al. (2019). “Effectiveness of Manual Therapy for Tendon-Related Conditions: A Review.” Journal of Musculoskeletal Research.
- Magnussen, R. A., et al. (2021). “Tendon Structure and Function: Implications for Rehabilitation in Achilles Tendinosis.” International Journal of Sports Medicine.
- Malliaras, P., et al. (2017). “Proprioception and Balance Training in Chronic Tendinopathy Rehabilitation.” Journal of Athletic Training.
Adaptive Physiotherapy & Massage in Booragoon is committed to using the latest evidence-based practices to deliver effective, personalized care for Achilles tendinosis and other musculoskeletal conditions, helping each patient achieve optimal health and performance.
