The Achilles’ tendon got its namesake from Greek mythology…

and for many with Achilles pain it can seem the road to recovery is a quest of mythical proportions!

We know it can be a challenge to demystify why Achilles pain occurs and keeps nagging.

Let’s dive in to the evidence and see the potential pitfalls and solutions…

think ‘strong’ not ‘stretch’!!

Most commonly pain in the Achilles region comes about after it experiences activity that is out of the ordinary.

Depending on your activity level this could range from running for the bus, walking on the beach or running 20 minutes when you only usually run 10.

If this type of overload occurs in an otherwise strong, healthy tendon then typically we are dealing with a ‘reactive’ tendon.

The pain and symptoms in this instance are basically complaints from the heel about being overworked!

A few weeks of modified activity, graded rehabilitation and anti-inflammatory medication (in certain cases) is sufficient to return to and exceed pre-injury activity levels. 

Oftentimes when pain presents itself life gets in the way, events that can’t be missed are approaching or we attempt to ‘push through the pain’.

In cases where an already aggravated Achilles is continually exposed to inappropriate (key word!) levels of activity, or overstretching (see pic) recovery can take longer. 

Symptoms persist because the tendon is being subject to stresses it is not able to deal with at its current level of strength.

Rest is definitely not best!

Exercise must be appropriately prescribed for the level you are at.

Whilst the tenants of management remain similar, the extent of rehabilitation is more robust with focus on restoring strength of the entire lower leg. 

In both instances resistance gym exercise is vital to restoring, and improving, strength of the Achilles and leg to prevent recurrence of symptoms. 

Brad Williamson

BSc. Physiotherapy, APAM