Working as a physiotherapist at the HPC, I encounter a number
of overuse type of injuries. Among elite and recreational exercisers,
achilles tendonitis is a common injury that can be very frustrating
to both the client and the physiotherapist. Achilles tendonitis
is an inflammation of the tendon and/or its surrounding sheath
and is primarily caused by repetitive stress. The following
are some of the more common causes of achilles problems.
Improper footwear: Change your shoes before they are
worn out. A good rule of thumb is to change your shoes approximately
every 500 km.
Walking/Running up hills: This type of training puts
incredible forces through the Achilles tendon. Be sure to gradually
add this type of intensity to your training.
Running on uneven terrain: To avoid injuries, be sure
to run on a variety of terrains.
Drastic change in activity levels: Avoid being a weekend
warrior!
Jumping activities: Jumping requires the tendon to contract
and stretch at high speeds which can lead to tendon breakdown
and inflammation. Be sure to gradually add this type of training
to your program.
Inadequate/improper stretching: Ideally stretching should
be performed after a 10 minute warmup of light exerise (e.g.
walking). Be sure to follow up with more stretching at the end
of your workout. The early symptoms of an acute achilles tendonitis
usually includes a gradual onset of pain, swelling and warmth
in the back of the ankle. Tenderness in the area of the tendon
is the most common complain and morning stiffness and tendon
thickening can also be present.
If you find yourself in this situation follow the RICE
principles of rehabilitation:
Rest - avoid all potential causes of the problem (e.g.
running, jumping, etc.) Ice - place a gel pack or bag
of crushed ice over the swollen Achilles for 10 min every hour
Compression - applying a tensor wrap may prevent further
swelling
Elevation - placing the injured achilles in an elevated
position may reduce swelling
It is important that if the early symptoms do not resolve in
1-2 weeks the client should seek professional evaluation and
treatment of the condition.
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