TENDINOPATHY - Achilles, patella and more
I plan to post information based posts from time to time, with the aim to help people understand their conditions, identify early injury risks and seek help before it stops them training. Please share and let me know if there is a topic you would like covered.
1. Tendinopathy can be caused by a number of factors, these can include sudden changes in activity, particularly walking, running and jumping, poor biomechanics, poor endurance for the activity targeted and systemic factors such as age, weight, menopause and more.
2. The typical symptoms include localised Achilles tendon pain that ‘warms up’ with activity. The pain is usually worse in the morning or after periods of inactivity but improves after 5-10min. For the Achilles the pain can be in the middle of the tendon, or where it attaches to the heel. For the Patella the pain is at the bottom of your knee cap.
3. In order to make it go away something needs to change. However, it is important to know that improvement is slow. So avoid short cuts, have patience and ensure you are doing the right exercises for you.
4. Passive treatments and rest are rarely the answer. The pain may settle but generally when you return to exercise the pain will return. The primary treatment should be a gradual increase in loaded exercise to increase tendon tolerance but adjuncts such as massage and acupuncture can be helpful.
5. In the short term, exercise reduction is important in conjunction with a personal rehab plan to help you progress.
6. Generally you can still run/walk/jump however the pain levels need to be strictly monitored and you must be honest with yourself. Use the 24HR RULE. If pain does not settle within 24hrs of loading, then it should be reduced further.
7. A physiotherapist can not only help manage the pain and teach you how to progressively load correctly, but they can also identify any biomechanical issues that may be contributing to your pain.
8. Changes seen on imaging such as an ultrasound DO NOT equal pain. It is common to have changes and no pain, and for you to return to full function with no improvement in the imaging picture. Therefore treatment should be focused at improving pain and function.
If you have any questions, please drop me a message or book in to see me. Please share far and wide.
Education is power.
These opinions are my own and my personal take on the topics.