The gastrocnemius + soleus (calf muscles) insert on to the Achilles tendon creating a musculotendinous junction. The Achilles tendon then inserts in to the calcaneus (heel bone).
Reactive Achilles Tendinopathy is a very frequent injury that occurs quite often in January. This is due to a period of inactivity over Christmas and people then resuming with a normal training regime in January. The Achilles tendon reacts to a sudden increase in training, after a period of inactivity, by thickening to reduce stress on the tendon.
Reactive Tendinopathy is the first out of three stages of the general term Achilles Tendinopathy:
Stage 1) Reactive – non-inflammatory stage
Stage 2) Dysrepair – tendon worsening
Stage 3) Degenerative - symptoms present more than 3 months = Achilles tendinopathy (repeated tendon overload).
Damage to the tendon is produced through increases in training or beginning training after a period of no training. There is no inflammation in this stage and it takes place in the short-term, to allow the tendon to cope with loads through thickening and stiffening. This stage is reversible and the tendon can return back to its normal structure if overloading/training is reduced with no long term effects.
Signs and Symptoms
The load, more often than not, has been increased too quickly for the tendon to adapt and so, it is advised to gradually increase your training regime back to normal rather than straight away. This will allow the tendon to adapt and reduce the risk of any Achilles tendon problems.
To prevent the injury developing from the Reactive to the Disrepair stage;
1/ Rest from aggravating activity for 5-10 days. This is key to allow the tendon to repair. During this process, non-weight bearing activities, such as swimming, cross trainer and cycling, are advised to maintain cardiovascular fitness.
2/ Gradual re-introduction to load through the tendon. Eccentric overloading is normally advised for Achilles Tendinopathy but, this type of exercise will aggravate the tendon in the Reactive stage. Stretching and Concentric exercises are advised to begin with. Tendons can take 24-48 hours to respond to activity, so don’t do too much too soon, and allow your Achilles tendon to rest 1-2 days between exercises.
3/ You can also adapt your training to reduce the load though the tendon and maintain some degree of load with isometric (static) contractions. These are effective at reducing pain and maintaining strength in the Reactive phase.
If you notice any stiffness or thickness in your Achilles, and you have only just got back in to training or your training regime has increased, then it is best to let them recover so you don’t cause any long lasting damage. A gradual increase in training is best to help prevent short and long-term injuries.
Always warm up before you exercise and stretch any relevant muscles after exercise. If you have any problems, seek professional advice from a physiotherapist or sports physician.
Suffering with any of these signs and symptoms?