Achilles tendinitis

Recurrent calf tendon pain

The calf muscle attaches at the calcaneus bone, also known as the heel.  There is a deep and a superficial calf muscle, called soleus and gastrocnemius respectively.  Some people can develop an imbalance in the tension of these muscles, which may contribute to the pathological forces in the Achilles tendon, so it is useful to get assessed to see if this needs addressing.  The roll of the ankle is also a factor because the tendon is dragged from side to side with every step, so it makes sense that if this is excessive it will irritate the tendon.

Treatment of Achilles tendinitis is based on the assessment.  People with tight calves, or tight sections of the different calf muscles get soft tissue and or dry needling as well as a home stretching program.  Those with ankles that roll in might benefit from better shoes or orthotics.  Osteopaths can also do a lot of joint mobilisation in the feet if unhelpful restrictions are present.  In difficult cases we might refer the patient to our podiatrist, especially if we cannot see the sorts of restrictions that we are skilled in mobilising.

Strengthening is an essential part of the management plan.  Tendons contain cells called tenosites, which are responsible for the rebuilding of an injured tendon, and which drastically drop in number and quality in these tendinitis cases.  The trick is to strengthen in a way that is appropriate for the stage of the injury so as to stimulate proliferation of tenosites without re-aggravating the problem.  Hence, it is not the sort of problem that you can just keep running through and it will eventually go away.