June 2020 Newsletter
What is Your Achilles Heel?
Achilles tendinopathy, most often known as Achilles tendinitis, is a common injury we see in the clinic. Although it can occur in the general population, it can be seen quite frequently in runners, soccer players and mountain climbers. About 9% of runners and as high as 18.5% of ultra-marathoners experience Achilles pain annually. It seems to increase as we increase in age. Most incidences of Achilles’ pain occur between the age of 30 and 50. Since we have seen more time participating in outdoor recreational activities like running and less time performing resistance training in the gym, we’d thought we would give you a little more information on the causes of Achilles pain and the best ways to combat it 1.
Why does my chance of getting an Achilles tendinopathy increase as I age?
In short, it’s complicated! But, as we age, the tendon may become a little thicker and lose its tensile strength. It cannot handle the stress we place on it. Believe it or not, there is also a genetic influence that predisposes someone to be at great risk of developing Achilles pain.
What are some other risk factors I should be aware of?
Additional factors that may predispose someone to Achilles tendinopathy includes obesity, rigid footwear, and limited ankle range of motion.
So now that I know what my risk is, how do I combat this?
Mobility
We know that having adequate ankle and calf mobility is important for normal forces to transmit during athletic activities. So here is a way to self-assess your ankle motion.
Ankle Dorsiflexion Test
Strength
The gastrocnemius and the soleus muscles (the muscles that make up your calf complex) are highly active during the propulsive phase of walking, running, and athletic activities. During running, the Achilles will experience 6-8 times the individuals body weight. Having adequate strength is important to ensure your Achilles can handle to load during running2. We like to see our athletes and runners perform 20-30 single leg calf raises with the knee straight (to challenge the gastrocnemius) and with the knee slightly bent (to challenge the soleus) on both sides.
Calf Strength Assessment
What about shoes? Does that increase my risk?
Yes. Rigid or motion control shoes can prevent shock absorption and increase risk of developing Achilles tendon issues. Check with your physical therapist or local shoe experts to choose that right shoe for you.
Hopefully this information will help you if you have dealt with Achilles tendon pain in the past or continue to deal with the issue. Please feel free to contact us for more information or schedule a free Discovery Visit with us to see if we are the right fit for you.
Dan's Pick
Half-Kneeling Ankle Mobilization
(click on the link to view)
This exercise will assist in improve ankle dorsiflexion by mobilizing the talus bone.
1. Begin in half-kneeling with the ankle you wish to mobilize in front
2. Place a band around the ankle in-line with the bottom ankle bones
3. Place resistance on the the band so it adds tension to your ankle
4. Rock forward so that the ankle bends; be sure to keep the heel on the ground
5. Hold for 2-3 seconds and repeat as instructed by your physical therapist
Matt's Pick
Calf Isometric Wall Drive
(clink on link to view)
This is a functional way to strengthen your calf muscle while incorporate hip stability and wall drive.
1. Begin by standing on the leg that you wish to strengthen
2. Flex your opposite hip and push it against the wall; you should feel the stance hip be activated
3. Once you feel balance and stable, drive onto your toes as if you were completing a calf raise
4. Hold 2-3 seconds and then complete as instructed by your physical therapist
This text, images, videos, and other materials have been provided as general information for exercise and rehabilitation and are intended for educational purposes. Any individual beginning mentioned, or beginning any other exercise program, should first consult with a qualified health professional. Discontinue any exercise that causes discomfort and/or dysfunction and consult with a qualified medical professional. Please consult with a physician prior to implementing any rehabilitation or exercise protocol.
Martin RL et al. Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2018 Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Orthopaedic Section of the American Physical Therapy Association J Orthop Sports Phys Ther. 2018;48(5):A1-A38. doi:10.2519/jospt.2018.0302
Lee, K.K.W., Ling, S.K.K. & Yung, P.S.H. Controlled trial to compare the Achilles tendon load during running in flatfeet participants using a customized arch support orthoses vs an orthotic heel lift. BMC Musculoskelet Disord 20, 535 (2019). https://doi.org/10.1186/s12891-019-2898-0
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