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Achilles Tendonitis Guide for Runners

Achilles tendonitis, also referred to as Achilles heel pain or Achilles tendinopathy, is the most common running injury. It typically occurs in one leg initially, but can also affect both legs as well.


Achilles tendonitis affects both men and women athletes who run at all levels, from recreational jogging to competitive marathoners. Running puts a lot of impact on the Achilles tendon with every foot strike, especially for long distances when you are fatigued. It can be treated with self-care strategies, but if it persists or worsens, the runner should see a physiotherapist for diagnosis and treatment.

This article will provide you with information about Achilles tendonitis so you can recognize it when it happens to you. Learn what treatments are available and how to prevent it in the future!

Factors that Attribute To Achilles Tendonitis in Runners

‘The Achilles tendon connects the calf muscles to the heel. Tension in the strongest and largest tendon in the body can be a source for running-related injuries such as Achilles tendonitis or plantar fasciitis. Running on hard surfaces can also increase your risk of injury due to additional stress on your foot and ankle joints compared with when running on soft surfaces. Other factors that can lead to Achilles tendon injuries in runners include:

  • Poor flat-arched feet
  • Tight calf muscles
  • Lack of flexibility in the plantar fascia ligament that leads to excessive pronation of the feet
  • Inadequate rest periods between workouts or over-training
  • Running shoes with worn-out cushioning

Muscle imbalances in runners can cause microtears, leading to Achilles tendon pain and swelling from excessive loading of the tendon during vigorous repetitive movements. As it is a degenerative disease, if left untreated, Achilles tendinitis can result in Achilles tendon tears or ruptures.

Achilles tendon rupture and Achilles tendonitis are both common injuries to the tendon. Ruptures occur when the Achilles tendon is either stretched beyond its capacity or torn because of a sudden change in direction during physical activity. Achilles tendon ruptures usually occur near the midportion while Achilles tendonitis typically affects both the superficial and deep portion of the tendon.


How Can Physiotherapy Help with Achilles Tendonitis?

Treatment of Achilles tendonitis is most effective when diagnosed early by a physiotherapist, but most athletes attempt to run the pain off, which leads to the continued fraying of the tendon. The Achilles tendon is a rich layer of vascularized cells. When injured, the blood vessels essentially fail to deliver enough oxygen and nutrients to the cells of these fibrous tissue.

With physiotherapy the goal is to restore pain-free movement by activating the extracellular matrix to regulate cellular healing function through manual therapy combined with non-invasive treatments such as Shockwave Therapy, Extracorporeal Magnetotransduction Therapy, or INDIBA Radiofrequency.


Shockwave Therapy’s Activates Reparative Healing

Extracorporeal Shockwave Therapy is a non-invasive procedure in which soundwaves are applied through the skin to the affected tissue. Soundwaves of different peak pressure and amplitude are emitted over a short duration administered by positioning an instrument over the injured area. The soundwaves activate the body’s reparative healing response by:

  • Increasing the natural formations of new blood vessels
  • Stimulating the reproduction of tenocytes to strengthen connective tissue
  • Promoting growth of osteoblast to secrete collagen to cover the surface of the bones
  • Activating white blood cells circulation towards the infected tissue
  • Synthesizing protein to increase collagen production

For post-op rehabilitation following Achilles tendon surgeries, Shockwave Therapy reduces the adhesion process at the onset of healing to quickly restore joint function. The therapy will also keep the tissues flexible, strong, and balanced to decrease the risk future injury.


Extracorporeal Magnetotransduction Therapy Boosts the Body’s Natural Healing Response

Musculoskeletal diseases like chronic and acute Achilles tendinopathy are common for athletes and runners. Extracorporeal Magnetotransduction Therapy (EMTT) by MAGNETOLITH is a useful modality for the treatment of tendinopathies to reduce pain and quicken the healing response with less risk of occurrence.

When a tendon injury occurs, upregulated nitric oxide synthases inhibits the tissue healing response. EMTT’s high frequency oscillation penetrates at a greater depth to enhance nitric oxide levels. Increased nitric oxide levels induce the production of cyclic guanosine monophosphates – the body’s natural signal to provoke tissue repair. Ultimately the activation of increased cellular response decreases pain and inflammation, regenerates tissues, and relaxes vascular muscles through blood flow stimulation.


INDIBA’s Promotes Oxygenation and Delivery of Nutrient

INDIBA’s subdermal healing accelerates tissue metabolism and regeneration. Tissue regeneration is a complex biochemical process. The regenerative effects of the radiofrequency technology increases the nutrient uptake and delivers more oxygen to affected areas to reduce swelling and bruising, and also to break-down scar tissue.

When the radiofrequency therapy is applied to an injured Achilles tendon, it produces a thermal effect to increase blood perfusion to meet the demand for necessary nutrient supply to the tissue and remove cellular waste. Through this physiological process, healthy vital tissue repair occurs.


Multiple Modality-Based Physiotherapy

Achilles injuries are complicated as pain may be associated with a number of physiological factors. So, if you are a runner with Achilles tendonitis, it is important to seek out treatment at the onset of injury. By combining both manual therapy with one or more technological treatments, HelloPhysio’s physiotherapists can help improve Achilles tendonitis through oxygenation, regeneration, collagen synthesis, and more, to reduce pain, decrease inflammation, and repair tissue to get you back running sooner.

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