Achilles tendinopathy is a relatively common injury in athletes. The injury involves damage to the fibres of the Achilles tendon, often at the narrow point of the tendon just above the heel. This area is most at risk as it has a poor blood supply and so is less able to repair itself.
The best treatment for this problem is an eccentric strengthening program. These exercises are usually quite painful. This does not mean that you are damaging the tendon further.
Exercises can be performed on the floor (without a step) or using a stair or step as shown in the above picture.
If these are too painful to begin with support some of you body weight with your arms - lean over a table or bannister
Ideally you should aim for 90 repetitions (45 with the knee straight and 45 with the knee bent) twice a day. This needs to be done for a period of 3 months.
After each set of exercises try to ice the painful area. This will improve pain and limit inflammation. In addition to strengthening it is important to identify activities which may be contributing to your pain and to aim for a reduction in overall loading. It is best to discuss this with your lead provider.
Achilles tendon rupture are common. Most athletes describe a sudden acute event with an associated popping sensation and pain in the Achilles tendon. They often think that they have been kicked or struck in the calf. It is important to get prompt treatment and to be placed in an equinous cast (a cast with the foot in a pointed position). More definitive treatment options can be discussed after this has occurred.
There are a number of treatment options available for patients with Achilles ruptures. In general these involve surgical repair of the tendon followed by casting or immobilisation of the tendon with the ends opposed (in an equinous position). There is often a lot of discussion about which is best. In reality there is no best solution for everyone and treatment decisions are made on an individual basis with the patient. The most important thing is to get the tendon to heal and for it to heal at its normal length. How this occurs is less important.
Mr Bruce Twaddle, one of the UniSports Orthopaedic Surgeons, has developed an accelerated non-operative treatment program for managing this injury. We have had good success with this regime in both recreational and elite athletes. This protocol uses a moonboot rather than with the plaster of paris cast which is generally used. The advantage of this protocol is that it allows you to do some basic ankle and foot exercises to limit muscle wasting and joint stiffness. In the later stages we are also happy for you to remove the boot for sleep.
If you would like to consider using this protocol ask your primary care provider to refer you to one of the Sports Physicians to see whether this might be appropriate for you.
Plantar Fascia pain or Plantar Fasciitis is a painful condition that affects the heel. Patients often notice pain when they put their heel down first thing in the morning. The exact nature of the injury is not known. The condition can be frustrating so requires a multi-faceted approach.
There are several factors which may increase the likelihood of developing this condition. These need to be assessed and corrected with direction from a physiotherapist to ensure an optimal outcome. Some of these factors include:
Consulting with a physiotherapist to confirm the diagnosis is important. Physiotherapist’s will advise on a management plan, usually consisting of activity modification (a reduction in playing and training) and addressing the contributing factors as outlined above. Treatment may include:
Examples of treatment: calf stretches, ice massage protocol