Achilles tendon injuries can be divided into insertional and mid-substance tendinopathy. These conditions require specific treatments tailored to each type.
Two Types of Achilles Tendon Injuries:
1. Insertional Achilles Tendinopathy: Pain occurs where the tendon attaches to the heel bone. This is aggravated by dorsiflexion, where the tendon gets compressed against the bone.
2. Mid-substance Achilles Tendinopathy: This occurs higher up the tendon, typically 2–6 cm above the heel. This area tends to respond well to loading protocols.
The Role of Tendon Loading
Progressive tendon loading is essential for Achilles tendon recovery. Starting with isometric holds, as recommended by tendon researcher Jill Cook, can reduce pain and help the tendon tolerate further load. Isometric exercises should be performed by holding contractions for 45–60 seconds, 3–5 sets, 3–5 times per day. This is particularly helpful for mid-substance injuries, while avoiding stretching is important for insertional tendinopathy to prevent further irritation.
Collagen Supplementation
Keith Baar’s research shows that collagen supplementation supports tendon repair. Taking collagen 30–60 minutes before exercise helps supply the necessary building blocks for tendon healing, especially when combined with loading exercises.
Updated Treatment Options
Manual therapy can accelerate healing by addressing tissue restrictions, improving mechanics, and enhancing mobility.
Deep Friction Massage and Active Release Technique (ART): These therapies target scar tissue and adhesions, improving tissue mobility and promoting collagen realignment in the tendon.
Foot and Ankle Manual Therapy: We also focus on joint mobilization and manipulation to improve dorsiflexion mobility and overall foot mechanics. This helps restore proper movement patterns, which are essential for long-term tendon health.
Additional Therapies We May Use
- Shockwave Therapy: Stimulates healing by increasing blood flow and cellular repair.
- Laser Therapy: Reduces inflammation and pain while promoting cellular regeneration.
- Dry Needling: Stimulates blood flow to the tendon, promoting repair and reducing pain.
By combining these evidence-based approaches, we provide comprehensive care for Achilles tendon injuries, helping you return to activity stronger and pain-free.
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