Achilles Tendinopathy: Acute and Chronic

Achilles tendinopathy is an injury that refers to a combination of functional changes affecting the Achilles tendon usually due to overuse and excessive stress upon the tendon. It may or may not be associated with an Achilles tendon tear, but a thorough examination can rule this out or refer for imaging if needed. A lack of mobility/stiff Achilles tendon can increase the risk of fully rupturing your Achilles tendon. An example of both are Kevin Durant, and Aaron Rodgers (complete rupture) vs Christian McCaffery (Achilles tendinopathy).

Even though tendinopathy of the Achilles tendon is often connected to sports activities, the ailment is also often found in people who do not practice sports. The biggest cause is the excessive overburdening of the tendon. A light degeneration of the Achilles tendon can be mildly present, but the pain only appears when the tendon is overburdened. It is also noted that the ailment is usually not preceded by a direct trauma.

There are two classifications of Achilles tendinopathy: acute and chronic. Achilles tendonitis is a synonymous term for acute Achilles tendinopathy and the time frame is typically 1-2 weeks from when initially felt. In Acute Achilles tendinopathy, you are more likely to experience swelling, and stretching/activity may increase your pain. As the tendinopathy becomes more chronic, the tendon actually degenerates and weakens further. Research shows that other risk factors include obesity, high blood pressure, rapid changes to load, prolonged steroid use, and other factors include inappropriate footwear.

The treatment of acute Achilles tendinopathy includes decreasing inflammation, ice for the first 72 hours, light stretching, and taping to biomechanically unload the Achilles tendon. We use world-class modalities like a Class IV laser or Winback Tecar therapy to effectively decrease pain and inflammation and enhance their recovery. This expedites the recovery process so that we can utilize the rehabilitative exercises with less pain and more mobility. In the case of chronic Achilles tendinopathy, there is scar tissue and degeneration of the tissue in which shockwave therapy would be the absolute best choice. Lower-level modalities like cupping, ice, stem, and vibration (hypervolt gun) therapy will NOT affect this. Early on in the rehab process, isometric and eccentric exercises are the most effective. We also address biomechanical issues at the foot/ankle, knee, and hip if they are contributing as well. As we progress, we can reincorporate plyometric and sport-specific movements so you are confident in your ability to load your Achilles tendon and return to doing what you love pain-free.

If you're dealing with an Achilles injury, Strength & Spine is the office for you. We see lots of lower extremity injuries and have everything needed to help. Schedule your FREE Discovery Visit today at strengthchiro.com