So what is it with achilles tendonopathy?

You may well have also heard it called achilles tendonitis or tendonosis but who cares what it’s called right? Technically speaking it’s a right old pain in the backside.

First of all you want to know exactly what it is. The term tendinopathy is commonly used as a collective term for tendonitis and tendinosis. Tendonitis (the most common term) implies inflammation of the tendon while tendinosis refers to tendon pain that occurs as a symptom of a series of microtears in the connective tissue in or around the tendon.

(picture courtesy of health central.com)

In recent weeks I seem to have had a spate of clients coming in to see me with this same persistent achilles problem which is really making me question what is going on. Surely it’s too many people for it to be coincidental. Surely it can’t be that everyone has taken up hill running with no training all at once. Of course if you google it you will find the usual gumpf about exactly what the causes of the condition are. Speak to a running coach and they will tell you its your running style and it is clearly an overuse issue due to all your inefficiencies. Talk to any kind of therapist and they will tell you its down to musculoskeletal dysfunction of some kind that needs to be treated using a variety of techniques including ultrasound, soft tissue work, joint mobilization, eccentric loading exercises, numerous taping strategies. Blah, Blah, Blah! Others will point the finger at environmental changes such as trainers wearing out, too much mileage in new trainers, running on uneven surfaces or up and down too many hills. Maybe it’s over pronation or supination which must surely need treating with expensive orthoses right? Maybe not…..

Although there are some innovative and pioneering approaches out there, more often that not these approaches can be expensive and are not readily available to most of us.

In my experience both personally and professionally there doesn’t seem to be any standardised protocol in resolving this annoying problem. I have had as much success treating this using the gentle approach as I have have had being more aggressive. For some, rest helps, others need more robust and often painful approaches designed to aggravate and re-stimulate the healing process. No two cases are the same. Perhaps it is time to think outside the box. Is there something else going on? For instance could we link this spate of injuries to the weather and climate conditions? What about stress? All I know is that we often find solutions to our problems in the last place we think of looking so I suggest keeping an open mind.

Of course you will be disappointed to hear that unfortunately I don’t have all of the answers. But, I can treat as I find, make suggestions and empathise!

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