Why is my Achilles hurting?

You may notice that in the mornings that the first few steps are quite stiff and painful, you have difficulty walking, or are sore to touch over the tendon. The tendon itself may have also thickened and it may be difficult to perform impact exercise. These can be the first signs of an Achilles tendinopathy. This can occur due to a long-term overuse of the tendon, or a recent increase in training load that lacks sufficient rest.

 You may have taken a period of time off running or training and then once returning, the pain comes back . This can be frustrating as it feels the pain is lingering longer than it should be, even after resting.

 If this sounds like something you’re going through, it is important you are thoroughly assessed by a physiotherapist. In the meantime, here are three things you can do to help yourself recover.

 Manage Your Loads

A common cause of Achilles tendinopathy is undergoing a fast increase in load, without the necessary rest. This could be as simple as getting back into walking after taking a few months off. You may have previously been able to walk 5km everyday, however after having time off, our bodies need time to adapt to an increase in load again. Therefore we need to gradually build up to achieving this. An easy way to determine your loads is to be guided by your pain; if you recognise that an activity is making you very sore afterwards, you’re probably doing too much.

 Modifying Activities

For those with Achilles tendinopathy, certain activities can be more aggravating than others, such as walking, jumping or running. One of the main aims of Achilles tendinopathy rehab is to calm the tendon down. This can be done by changing the way we complete our activities so the tendon is not constantly aggravated. An example of this is still going to footy training, however limiting the amount of jumping or sprinting you complete, just for now.

 Build Up Strength

It is important to note that complete rest is not recommended, and can actually be harmful to the tendon and may prolong recovery. Therefore, it is important to start building up your strength in ways that don’t load the tendon too much. Examples of this include doing exercises such as a calf raise with a slow, controlled motion, hydrotherapy and isometric exercises (holding a position). As you slowly build up strength, your physiotherapist will be able to progress your exercises tailored to your goals, such as returning to jumping.

 Early intervention and management of Achilles tendinopathy can help you get back to everyday life and the things you love. A physiotherapist can assist you by completing an in-depth assessment and tailoring your treatment to your specific symptoms and goals.

FAI is a very common cause of hip pain in athletes playing sports such as soccer, football (AFL) and ballet.

These sports often require repetitive movements that can exacerbate hip impingement symptoms over time.

It occurs during adolescence where repetitive movements in the end ranges of the hip cause increased bone growth around the ball or socket of the hip. It is important to note however, that 40% of adults have signs of FAI on CT scans but do not have pain (Kim et al., 2015). This indicates that signs of FAI on scans do not need to change in order to get out of pain – and therefore the presence of bony “deformities” on a scan is merely one piece of the puzzle.

Athletes will often present with a “C-sign” pattern of pain – where when describing their pain, they place their hand on their hip with the index finger towards the front of the hip and their thumb towards their glutes. It can also present as groin pain and associated tightness. Additionally, they may have issues during deep squatting or rotating their hips.

Over time, FAI when not treated well does have some correlation with early onset hip osteoarthritis (Wyles et al., 2017). This highlights how important physiotherapy can be to manage this condition.

At Goulburn Valley Physiotherapy Centre, our approach to treating FAI is comprehensive and evidence-based. We begin with a thorough assessment to determine the specific biomechanical factors contributing to the impingement – such as objective muscle strength and pelvic/hip control. Treatment strategies typically include:

• A strength and conditioning program
• Education on short and long term management
• Manual therapy as appropriate

If you are suffering from hip impingement issues get in contact with us today!

 

 

Kim, J., Choi, J.-A., Lee, E., & Lee, K. R. (2015). Prevalence of Imaging Features on CT Thought to Be Associated With Femoroacetabular Impingement: A Retrospective Analysis of 473 Asymptomatic Adult Hip Joints. American Journal of Roentgenology, 205(1), W100–W105. https://doi.org/10.2214/ajr.14.13130

Wyles, C. C., Heidenreich, M. J., Jeng, J., Larson, D. R., Trousdale, R. T., & Sierra, R. J. (2016). The John Charnley Award: Redefining the Natural History of Osteoarthritis in Patients With Hip Dysplasia and Impingement. Clinical Orthopaedics and Related Research, 475(2), 336–350. https://doi.org/10.1007/s11999-016-4815-2