Running is an excellent way to get fit! However, sometimes when we start a new program we can feel little niggles beginning to arise. Achilles tendinopathy is a common injury among runners, especially those who are increasing their training load.
What is the achilles?
The achilles tendon is the biggest and strongest tendon in the body located in the back of the lower leg. The tendon has the capacity to resist large forces. It stems from the calf muscles (the gastrocnemius and soleus) and inserts into the heel of our foot (the calcaneus).
What is Achilles Tendinopathy?
A tendinopathy is a disorder which can happen when there is disrepair and disorganisation within the tendon structure. This can happen when there is excessive load placed on the structure, for example if someone starts running and increases their mileage too quickly.
The effects of overuse, poor circulation, lack of flexibility, gender, and hormonal factors can lead to tendinopathies. The structure of the tendon is disturbed by repetitive strain, causing inflammation. This cumulative microtrauma weakens the tendon, which ultimately leads to tendinopathy, especially if recovery is not allowed.
Tendinopathies are a common source of pain in athletes. However for coaches and patients it can be difficult to understand and acknowledge in training and competitions. They develop over the course of preseason where the intensity of the training is increased. Stereo-typically athletes experience an aching tendon or region at the start of a session, ease off once the tissue is warmed up and then a dull ache the next day for 24hours, slightly more than normally. If the ache in question is worse for greater than 48hours, the sporting activity is likely too much for the tissue at that time and a rehab plan should be started.
More recently I have seen an increase in the number of patients coming through our door with pain on the outside of their elbow.
With increased demands at work ( keyboard, mouse or repetitive use of tools) , Sport ( repetitive sports like Tennis, Squash or Golf) and increased use of our mobile phones there can be an overuse repetitive strain on the extensor muscles of the forearm. The extensor muscles of the forearm are attached to the outside ‘lateral’ aspect of the elbow. Previously it has been called an inflammatory condition but with new recent evidence its actually more a tendinopathy and the inflammatory part is only present in the early stages. With tendinopathies there is different changes to the tissue and can mean different ways on how we manage the tendon compared to previous strategies.
Plantar fasciopathy has been used as the new name for plantar fasciitis and it makes good sense why.
Plantar fasciopathy can be a runner’s nightmare. Athletes are training really hard, trying to increase their training load for the upcoming races and boom, they start to get pain in the bottom of their foot or heel.