Achilles tendinopathy: Pt II
Asymmetric running is associated with pain during outdoor running in individuals with Achilles tendinopathy (AT) in the return-to-sport phase.
Achilles tendinopathy prevalence amongst runners is as high as 10%, with recurrence rates approaching 27%. In 2020, Paavola et al. published a sobering long term follow up paper on AT showing despite 94% of subjects eventually returning to prior activity levels, 41% went on to experience symptoms on the non-injured side, with side-to-side differences persisting at the eight-year mark.
Exercise, loading, and incremental activity progression have long been established as the most effective means to improve symptoms in those with AT.
Previous research has been relatively short and unable to show asymmetries and their effect on AT pain.
Anyone rehabilitating a tendon should take 2-3 days recovery between bouts of intense exercise while their tendons are still recovering.
Key Points/Results:
Recreational runners run anywhere from 3 to 12 times over a 2 week period (avg. 7). Total number of run days did not appear to be significantly related to change in pain or symmetry. Greater AT pain was linked to greater loading of the opposite leg, over consecutive days. More consecutive days ran, the stronger the relationship between pain and asymmetry becomes. Greater ground contact time on the healthy limb was associated with more AT pain on the injured side.
Recreational runners with AT demonstrate altered mechanics well into their return to sport phase of rehabilitation.
The presence of AT pain is associated with underloading the affected leg during running bouts of 30 minutes or more.
Long term studies have shown low level achilles tendon symptoms may persist for years after returning to prior activity levels.
If you are recovering from long term Achilles Tendinopathy, it is possible there is asymmetry in your running. If this is the case, come in and see one of our Physiotherapists for a thorough assessment and management plan. To book an appointment call 9245 7007 or send an email to admin@horizonphysio.com.au
