SPORTS IN­JURIES ACHILLES TEN­DON

Re­turn­ing to sport af­ter an Achilles ten­don in­jury

Great Health Guide - - CONTENTS - Mar­garita Gure­vich

In­juries to the Achilles ten­don are ex­tremely com­mon. Not only are they of­ten quite painful but they can also be very de­bil­i­tat­ing and put a per­son out of par­tic­i­pat­ing in their favourite sport/phys­i­cal ac­tiv­ity for quite a while.

The fol­low­ing are a few tips on re­turn­ing to sport af­ter and Achilles ten­don in­jury. Please note these tips are only gen­eral and are not a sub­sti­tute for see­ing a trained health pro­fes­sional. If in doubt about the sever­ity of an in­jury, you should see your doc­tor or phys­io­ther­a­pist for an as­sess­ment. First of all what are ten­dons? Ten­dons are

the strong fi­bres that con­nect mus­cles to bones. Ten­dons are made pri­mar­ily of col­la­gen. The Achilles ten­don is the thick­est in the hu­man body. It at­taches from the calf mus­cles (plan­taris, gas­troc­ne­mius and soleus) to the heel bone (cal­ca­neus).

TEN­DONITIS VS. TENDINOSIS

These two terms are of­ten mis­taken for one an­other – yet they de­scribe two very dif­fer­ent things.

Ten­donitis: this de­scribes specif­i­cally in­flam­ma­tion of the Achilles ten­don.

Tendinosis: this refers to mi­cro-tears of the ten­don.

One symp­tom may com­monly ac­com­pany the other. It is not al­ways clear which was present first. In many cases the treat­ment op­tions may over­lap. How­ever, it is still im­por­tant to have an idea of what is caus­ing the pain, so as to pre­scribe treat­ment that is spe­cific to the is­sue. For ex­am­ple: anti-in­flam­ma­tory med­i­ca­tion will be of lit­tle use when there is no in­flam­ma­tion ac­tu­ally present.

WHAT ARE THE CAUSES?

These in­juries are typ­i­cally caused by overuse, es­pe­cially in sports where a sig­nif­i­cant amount of run­ning or other repet­i­tive tasks are re­quired. Usu­ally the on­set is grad­ual – com­monly de­scribed as ‘wear and tear’.

Com­mon causes are: over-train­ing, tight Achilles ten­don (some­times as­so­ci­ated with a high foot arch), flat (over-pronated) feet, tight ham­strings or calf, poor footwear, hill run­ning or poor ec­cen­tric strength (the strength re­quired to con­trol the move­ment of run­ning down­hill for ex­am­ple).

TREAT­MENT

A thor­ough treat­ment pro­gram is the best way to pre­vent re­cur­rence of this is­sue. Re­turn­ing to sport too quickly will mean that the prob­lem is likely to linger un­til enough rest and proper re­ha­bil­i­ta­tion mea­sures are un­der­taken.

Ini­tial re­cov­ery, de­pend­ing on the sever­ity of the in­jury, should in­volve some el­e­ments of the RICE pro­to­col – Rest, Ice, Com­pres­sion and El­e­va­tion. This is to re­duce the load be­ing placed on the in­jury and be­gin to re­duce the

THE TERM TENDINOPATHY IS NOW COM­MONLY USED, AS IT EN­COM­PASSES BOTH IN­FLAM­MA­TION AND MICROTEARS.

in­flam­ma­tion that may be present. The RICE pro­to­col is typ­i­cally fol­lowed for 48 hours.

In or­der to speed up the re­cov­ery process other treat­ment modal­i­ties are of­ten used. These of­ten in­clude ul­tra­sound, elec­trother­apy, SCENAR ther­apy, heat packs and soft tis­sue mas­sage. Make sure though that you don’t use heat packs or soft tis­sue mas­sage in the first 48 hours fol­low­ing the in­jury.

Once the ini­tial pain and in­flam­ma­tion are un­der con­trol the fo­cus will shift to­wards a spe­cific ex­er­cise pro­gram. This is a cru­cial step in the re­cov­ery pur­pose. While the treat­ment meth­ods de­scribed above will help to re­duce the symp­toms, the only way to main­tain the re­sults and re­duce the risk of sus­tain­ing the same in­jury in the fu­ture, is to do spe­cific strength­en­ing and range of mo­tion ex­er­cises.

WHAT TYPES OF EX­ER­CISES ARE GEN­ER­ALLY PRE­SCRIBED?

A lot of peo­ple think as fol­lows: I have in­jured my Achilles ten­don, so nat­u­rally I need to work my an­kle. True? Yes, up to a point but this state­ment needs ad­di­tional clar­i­fi­ca­tion.

Over the years we have helped many pa­tients who have sus­tained Achilles ten­don in­juries. We al­ways ex­plain that fo­cus­ing on the an­kle alone will not achieve op­ti­mal re­sults. It’s cru­cial to work on the whole ki­netic chain, i.e. your pelvis, hips, knees and an­kles. Why? Think of the fol­low­ing sce­nario: you have an old sports in­jury which has af­fected your hip. While you might no longer no­tice this much, now that you also have an in­jured Achilles ten­don, the weak­ness of the hip

will ex­ac­er­bate the prob­lem as more load will be go­ing through the an­kle. Hence by strength­en­ing the hip, the ad­di­tional load go­ing through the an­kle will be re­duced.

SPE­CIFIC ACHILLES EX­ER­CISES IN­CLUDE THE FOL­LOW­ING:

Strength­en­ing: slowly build­ing up the strength of the calf mus­cles, in­clud­ing ec­cen­tric strength­en­ing (typ­i­cally per­formed by low­er­ing the heels off the edge of a step)

Range of mo­tion ex­er­cises: im­prov­ing the mo­bil­ity of the an­kle; stretch­ing is of­ten part of such ex­er­cises

Bal­ance and pro­pri­o­cep­tion ex­er­cises:

im­prov­ing the bal­ance and the aware­ness of the joint in space; this makes you less likely to sus­tain the same in­jury in the fu­ture

Equip­ment such as foam rollers, ther­a­bands, an­kle weights and Swiss balls are just a few of the po­ten­tial tools that may be utilised. Your phys­io­ther­a­pist can ad­vise what is most ap­pro­pri­ate for your spe­cific in­jury and also pro­vide you with an ex­er­cise pro­gram which has been de­signed specif­i­cally for you.

Mar­garita Gure­vich is Se­nior Phys­io­ther­a­pist at Health Point Phys­io­ther­apy. Bach­e­lor of Phys­io­ther­apy (La Trobe Uni­ver­sity) & Diploma of SCENAR Ther­apy (Moscow). Mar­garita uses Clin­i­cal Pi­lates, SCENAR ther­apy and other ev­i­dence-based tech­niques spe­cial­is­ing in in­con­ti­nence and women’s health.

YOUR EX­ER­CISE PRO­GRAM MUST AD­DRESS NOT ONLY THE ACHILLES TEN­DON BUT ALSO YOUR CORE, HIPS AND KNEES.

Newspapers in English

Newspapers from Australia

© PressReader. All rights reserved.