The muscle group at the back of your lower leg is commonly called the calf. The calf comprises of 2 major muscles called the gastrocnemius and soleus. Both of these muscles insert into the heel bone via the Achilles tendon. During contraction of the calf, tension is placed through the Achilles tendon. When there is too much force, the Achilles tendon can tear, this is referred to as a tendinopathy. A tendinopathy can therefore be caused by trauma of a sudden excessive force places though the tendon, repetitive forces placed through the tendon or general degeneration with age or wear and tear. Tears to the Achilles tendon can range from a small partial tear, to a complete rupture.
What are the symptoms of an Achilles Tendinopathy?
An Achilles tendon rupture often presents as a severe sudden pain in the Achilles region, an inability to bear weight on the injured leg. Some individuals may describe an audible ‘snap’ or ‘tear’ sound, or the sensation of being kicked or hit in the back of the leg at the time of injury.
A partially torn Achilles tendon, will involve a sudden onset of Achilles pain during an activity. Symptoms may increase during activities which place strain on the Achilles tendon such as walking (especially uphill), going up and down stairs, running, jumping, hopping, or when performing heel raises or calf stretches. It is also common for patients to experience pain after these activities with rest, for example waking in the morning after. Swelling in the Achilles region and pain on firmly touching the Achilles tendon are also common.
Patients with Achilles tendonitis or a degeneration of the Achilles may experience swelling, tenderness on firm touch to the Achilles tendon, weakness and palpable thickening of the affected Achilles tendon when compared to the unaffected side. They may experience noticeable stiffness and pain in the night or mornings especially after performing aggravating activities such as walking, hopping, jumping.
How can physiotherapy help?
A physiotherapist can massage the area to realign the tendon fibres whilst increasing blood flow to enhance the healing process. Rest is important in the early stages and the physiotherapist may provide some support such as strapping or bracing. Furthermore, with healing progress the physiotherapist may advise on stretching & strengthening exercises. Further treatment options are also available such as acupuncture to promote natural healing of the tendon or mobilisation to encourage a return to mobility of the joint.