The 2 biggest mistakes that prevent Achilles tendon pain from get better?

Despite being an extremely common condition, it is a condition that so many people struggle with  for months or even years. We are going to breakdown the key reasons why and help you avoid making the same mistakes.

Mistake 1 - Completely resting the tendon

Unlike a bone or a muscle, a tendon cannot heal itself with rest. This is an undeniable fact and a reason why so many achilles injuries go on for months or even years. A key reason for this that a tendon has a low metabolic rate and a decreased blood supply when compared to other structures in the body. 

This means that the tendon physically cannot repair the injured tissue while you are sitting down watching tv or lying in bed asleep. As an Achilles tendon injury is a painful condition, many people fall into this trap of resting it to let it settle down, but they continue to do this for far too long. If the Achilles tendon is acutely painful and swollen, it is a good idea to rest for a short period of time so that you stop aggravating the injured tissue. It is not a good idea to keep doing this for weeks, months or years. 

So what should you do? 

You need to help the tendon to heal by doing something to activate a healing response in the tendon. You have to give that tendon a healing hand for it to get to work and repair the injury. The most effective way to do this is by using strengthening exercises to apply as force to the tendon. When the tendon is placed on a force, it gets a cue from the body to adapt. 

Just like muscles get bigger by going to a gym and lifting weights, and bones become less dense when people go into space. The tendon, like anything else in the body will adapt to what you do to it. If you put it under a small amount of force, the body will recognise this and respond by releasing chemicals and increasing blood flow to the area. The body will get to work by repairing and strengthening the tendon.

Mistake 2 - Fighting the inflammation

We are always taught that inflammation is bad and that when it is there, it is important to get rid of it. However, when we have a tendon injury the opposite is true. 

Inflammation is our bodies natural healing mechanism. It is your body getting to work to repair the injury and without it, the tissue cannot heal. 

So many times, I see people that are using excessive amounts of anti-inflammatory medication or ice on their Achilles tendon. It is usually to try and combat the pain, but it is bringing your body’s healing mechanism to a grinding halt. 

When trying to resolve an injury like an Achilles tendinopathy, we want to regulate the body’s inflammatory process, not stop it altogether. This is how I explain this in clinic, 

‘Imagine that you inflammation is a car driving on the motorway. We want the car to be moving at a consistent steady speed. We don’t want it to get carried away and go over the speed limit, nor do we want it to slow down to a complete stop. We need to control the speed by using tools like heat, ice, movement and medication; just like they are our accelerator and brake pedals.’

Now don’t get me wrong, we can still use ice and NSAIDs like ibuprofen but only if we need to slow the car down. If we have really aggravated that tendon and are suffering with increased pain and swelling then they are great tools at calming it down and bring it back under control. This means that they should only be used short-term, before returning to your strengthening plan.