WHAT ELSE TO TRY

Athletics Weekly - - Performance -

Vary where you run: For ex­am­ple, run on grass or trail in­stead of road to re­duce the load put through the Achilles ten­don. Sim­i­larly, re­assess the choice of footwear.

Change your footwear: Many run­ners who suf­fer with Achilles tendinopathies have a hy­per­pronated run­ning style. This is the move­ment of the sub­ta­lar joint into ev­er­sion, dor­si­flex­ion and ab­duc­tion.

Find­ing a sup­port­ive shoe to help coun­ter­act some of this move­ment will re­duce the sus­cep­ti­bil­ity to such in­juries.

Avoid steroid jabs: NICE does not sup­port the use of steroid in­jec­tions as a recog­nised treat­ment for Achilles tendinopathies as there’s an in­creased risk of ten­don atro­phy or rup­ture.

Try shock wave ther­apy: With this treat­ment, acous­tic shock­waves

are passed through the skin and di­rected at the Achilles ten­don with the aim of boost­ing blood flow to the area and pro­mot­ing re­growth of the ten­don in a lin­ear fash­ion.

Look for lasers: Low level laser ther­apy is thought to in­crease col­la­gen pro­duc­tion and re­duce blood flow in new ves­sels. It’s best used as ad­juncts to ec­cen­tric Achilles ex­er­cises.

Surgery as a last re­sort: Rarely,

re­sis­tant Achilles tendinopa­thy may re­quire open surgery to ex­cise fi­brous ad­he­sions and de­gen­er­a­tive nod­ules. Sur­gi­cal meth­ods are of main ben­e­fit in acute rup­ture as op­posed to tendinopathies. Younger ath­letes with full rup­ture are more likely to ben­e­fit from sur­gi­cal re­pair as risk of re-rup­ture is re­duced. With a pos­si­ble fu­ture sport­ing ca­reer the ben­e­fits of surgery are likely to out­weigh any risk.

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