The Achilles tendon is the largest and strongest tendon in the body. The muscles soleus, gastrocnemius and a thin muscle known as plantaris make up this powerful tendon which attaches to the calcaneus (heel). The tendon serves as an energy storage and release structure, therefore it is vital for running, walking, jumping, hopping and change of direction movements.

As this tendon is involved in all locomotive activities we perform, it is loaded frequently and with great amounts of force. All tissues in the body have a load capacity, if this capacity is exceeded then an injury results. In the case of tendons, they react and become a tendinopathy (which may have a component of inflammation). If inflammation is present, then it is named Achilles tendinitis.

This injury is prevalent in runners, where elite runners have a lifetime prevalence of up to 52%. Although common in runners, it is also prevalent in the sedentary population. Studies have shown that about one third of all Achilles tendinopathy complaints are experienced in those who live a sedentary lifestyle.

The risk factors for this injury are quite vast and more clear research is needed to make certain conclusions. However, those who are obese, smoke, diabetics, or just have poor metabolic health are at an increased risk. Those who are older typically have less elastic properties in their tendons and as such are at an increased risk of developing an Achilles tendinopathy.

What is probably the most important factor in Achilles tendinopathy is that it is unique in the fact its pathology site can include the mid-portion. Most tendon reaction injuries only include where the tendon inserts into the bone, this is usually where it can become more compressed. An accurate diagnosis for what type of Achilles tendinopathy pathology is present is crucial for appropriate management. Your osteopath at The Reform Lab Osteopathy will be able to identify if your tendon injury is insertional, mid-portion or even a paratenon pathology. The paratenon is the sheath that the Achilles is protected by. It can become irritated and its pathology and management is also unique.

The Reform Lab Osteopathy will get you your answers and take you through a structured rehabilitation plan in the elite gym Project Reform.

Ensure you read our informative blogs ‘The Achilles Heel – What is that pain at the back of your heel?’ & ‘Tendon Reaction Injuries’