Achilles Tendonitis

Achilles Tendonitis

Achilles tendonosis, also known as Achilles tendinopathy, is a condition characterized by chronic degeneration of the Achilles tendon, which connects the calf muscles to the heel bone. Unlike Achilles tendonitis, which involves inflammation, tendonosis is associated with microscopic tears and structural changes in the tendon. This condition typically develops over time due to repetitive stress or overuse.

Symptoms of Achilles Tendonosis:

  1. Pain and Stiffness: Persistent pain and stiffness along the Achilles tendon, particularly in the morning or after periods of inactivity.
  2. Thickening of the Tendon: The tendon may become thickened and feel nodular to the touch.
  3. Weakness and Limited Range of Motion: Weakened calf muscles and a reduced range of motion in the ankle joint.

Physical Therapy Options for Achilles Tendonosis:

  1. Therapeutic Exercise:
    • Eccentric Strengthening: Eccentric exercises focus on lengthening the muscle-tendon unit under load. Eccentric strengthening of the calf muscles has been shown to be effective in Achilles tendonosis rehabilitation.
    • Calf Raises and Toe Raises: Controlled calf raises and toe raises help improve strength and flexibility in the calf muscles and the Achilles tendon.
  2. Stretching and Flexibility Exercises:
    • Gastrocnemius and Soleus Stretches: Targeted stretches for the gastrocnemius and soleus muscles can enhance flexibility and reduce tension in the Achilles tendon.
    • Achilles Tendon Stretching: Gentle stretches for the Achilles tendon can be beneficial, but they should be performed cautiously and within a pain-free range.
  3. Manual Therapy:
    • Massage and Soft Tissue Mobilization: Hands-on techniques by a physical therapist can help reduce muscle tightness and improve blood flow to the affected area.
    • Joint Mobilization: Gentle joint mobilization techniques may be applied to improve ankle joint mobility.
  4. Modalities:
    • Ultrasound and Laser Therapy: These modalities can promote tissue healing and reduce inflammation.
    • Electrotherapy: Electrical stimulation may be used for pain management and to stimulate healing.
  5. Biomechanical Assessment:
    • A thorough assessment of gait and foot mechanics can help identify any contributing factors, such as overpronation or improper footwear. Orthotic devices may be recommended to address these issues.
  6. Activity Modification and Load Management:
    • A physical therapist can guide individuals in modifying activities to reduce stress on the Achilles tendon. This may involve adjustments to exercise intensity, frequency, and duration.
  7. Functional Rehabilitation:
    • Incorporating functional activities and sport-specific exercises helps ensure a safe return to activities and prevents re-injury.
  8. Education:
    • Providing education on proper warm-up techniques, footwear selection, and gradual progression of activities is essential for long-term management.

It’s important for individuals with Achilles tendonosis to seek professional guidance for a personalized treatment plan. Physical therapy plays a crucial role in addressing the underlying factors contributing to tendonosis, promoting healing, and preventing future recurrences. Early intervention and a comprehensive approach often yield favorable outcomes in the management of Achilles tendonosis.