“Achilles Heel” – Achilles tedinopathies hamper training schedules!!

As preparation for late summer and autumn marathons continues Achilles Tendinopathies  are one of the most common causes of missed training miles/hours. The terminology used to describe them is often inaccurate and is undergoing a significant transition. First to be precise we must consider where along the course of the tendon does the problem exist

Achilles Tendinopathies

  • Increasing incidence of overuse injuries in  all sports
  • caused excessive repetitive overload of the tendon
  • Affects athletes, fitness enthusiasts and even inactive people
Do I Have a Tendinopathy or Tendinosis??
  • Tendinopathy: generic descriptor of the clinical conditions in and around tendons arising from overuse
  • Tendinosis: tendon degeneration without clinical or histological signs of inflammation
  • Tendinitis: inflammation of the tendon itself. Rarely occurs histologically
  • Paratenonitis: includes peritendinitis, tenosynovitis and tenovaginitis
The Achilles TendonImage
  • —Thickest and strongest tendon in the human body
  • —Combined tendon of the gastrocnemius/soleus muscle
  • —Has no synovial sheath
  • “hypovascular” – poor blood supply

Up to 12 times your Body Weight is transmitted  through your Achilles tendon when sprinting!

 Clinical Presentation
  • often coincides with  an increased training intensity or volume
  • —may come on gradually
  • —morning stiffness after a tough training session
  • —may actually improve with activity and training but pain increases post training
 Causes/Risk factors
There are several factors that can contribute to the development of Achilles issues, It’s rarely one in isolation.
  • increase in activity – eg increasing in mileage too quickly  (distance, speed, gradient)
  • —not enough recovery times between hard  training sessions
  • —change of surface, footwear
  • —increased load on the calf muscles
  • —calf weakness, poor muscle flexibility, restricted joint range of the ankle
  • decreased forefoot flexibility
  • genetic predisposition


  • relative rest – reduce/change training
  • review footwear
  • Assess flexibility and strength of lower limb
  • improve running technique/footstrike and biomechanics

Treat it early and don’t let this happen!!

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I qualified with an Honours degree in Physiotherapy from Trinity College Dublin in 2004. Since graduating I have worked in St. James Hospital Dublin and have worked in all the areas of speciality within the hospital including cardiorespiratory, orthopaedics, rheumatology, care of the elderly, neurology, burns and plastic surgery among others . I have also completed a post graduate certificate in acupuncture in UCD 2009. The Physiotherapy Department in SJH has strong links with Trinity College Dublin (TCD) and I have supervised undergraduate and postgraduate physiotherapy students on practice placements and also delivered lectures on the undergraduate academic programme in TCD. I have a keen interest in all sports and currently plays with Cill Dara RFC 1st team squad, and Milltown GAA. I have previously worked as Physiotherapist to Co. Carlow Senior GAA Team, Milltown GAA, Leinster Junior Rugby Team and Cill Dara RFC. I am an experienced runner and competed in the Dublin City Marathon in 2002. I continue to participate in running events and multisport disciplines such as Gaelforce West, Gaelforce North and the Motivate Challenge. I have a particular interest in strength and conditioning. I utilise this knowledge of resistance training in the treatment of his clients. I am committed to continuous learning and development in order to ensure the optimal level of care is offered to my clients, and with this in mind I am currently undertaking a certification in Strength and Conditioning (CSCS) with the NSCA.

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