Blog 1: Understanding Achilles Tendinopathy

Part 1: What is Achilles Tendinopathy? The Injury That Sneaks Up on You

Ever notice how your heel feels a bit stiff in the morning, but you think "meh, I'm just getting older"? Then one day you're hobbling around like you're 90 years old, wondering what the heck happened to your Achilles tendon?

Welcome to Achilles tendinopathy—the sneaky injury that loves to crash endurance athletes' parties uninvited.

As an endurance athlete myself and chiropractor who sees this all too often, let me break down what's really going on back there (and why it's not just "getting old").

So... What Exactly IS Achilles Tendinopathy?

Think of your Achilles tendon as the thick, rope-like structure connecting your calf muscles to your heel bone. It's basically your body's built-in spring system for walking, running, and jumping.

Achilles tendinopathy is when that "rope" gets angry, disorganized, and stops doing its job properly. It's like having a frayed climbing rope—it might still work, but you definitely don't want to trust it with anything important!

Here's the plot twist: Most people call it "Achilles tendinitis" (with an "itis"), but that's usually wrong!

Tendinitis = Angry, inflamed tendon (pretty rare)

Tendinopathy = Grumpy, degenerated tendon (what most people actually have)

It's like calling every tissue box "Kleenex"—we all do it, but it's not technically correct!

The Two Types (Because Life Wasn't Complicated Enough)

Type 1: Insertional Achilles Tendinopathy

- Happens right where the tendon attaches to your heel bone

- Often comes with bonus features like bone spurs (lucky you!)

- More common if you're a bit older or have super tight calf muscles

Type 2: Non-insertional (Mid-substance) Achilles Tendinopathy

- Happens about 2-6 cm up from your heel

- More common in younger, active people

- Usually responds better to treatment (silver lining!)

How Do You Know If You Have It?

Your Achilles tendon has a few ways of getting your attention:

Early Warning Signs (Your tendon is being polite):

- Morning stiffness that improves once you get moving

- A little achy at the start of your run, then feels fine

- Mild puffiness or thickness you can feel

- Tender when you pinch the tendon

Getting More Serious (Your tendon is raising its voice):

- Pain during AND after exercise

- Stiffness that hangs around for more than 30 minutes

- Visible swelling or lumpy areas

- Walking uphill or upstairs becomes unpleasant

Red Flag Status (Your tendon is SHOUTING):

- Pain even when you're just sitting around

- Significant trouble with daily activities

- The tendon looks obviously thick or deformed

- You can't rise up on your toes without wincing

Why Does This Happen to Good People?

Achilles tendinopathy is rarely caused by one dramatic moment (like in the movies). It's more like death by a thousand paper cuts, like a lot of other overuse injuries. Here's what usually creates the perfect storm:

Training Oops Moments:

- The classic "too much, too soon" scenario

- Becoming obsessed with hill repeats or speed work

- Skipping rest days because you're "feeling strong"

- Coming back from time off like you never left

Your Body's Unique Quirks:

- Tight or weak calf muscles (or both -- you overachiever!)

- Stiff ankles that don't move well

- Hip weakness that makes everything else work harder

- That special running form you've perfected over the years

Life Stuff:

- Previous Achilles adventures you didn't fully recover from

- Getting older (unfortunately we don't stay invincible forever!)

- Certain medications that don't play nice with tendons

- Genetics (thanks, family!)

Why Endurance Athletes Are Sitting Ducks:

We endurance folks are basically asking our Achilles tendons to be superheroes with the thousands of foot strikes per training session. Or not spending enough time recovering from harder workouts with high weekly training volumes because more is better, right?

The Stubborn Factor:

As humans sometimes we get way too good at ignoring early warning signs. "I'll just run through it" is basically our motto. Having a busy schedule week to week where you might have to fit workouts in at times that are less than ideal for what your body needs.

Some More Important Factors Contributing to Injury:

Poor Blood Supply: The middle part of your Achilles tendon has about as much blood flow as a desert has water. This means it heals slower than other body parts and gets grumpy more easily.

Heavy Load Demands: During running, your Achilles tendon handles forces up to 12 TIMES your body weight. That's like asking a garden hose to handle fire truck pressure!

The Aging Thing: As we get older, our tendons naturally become a bit less springy and more sensitive. It's not your fault—it's just biology being biology.

Let's Bust Some Myths

Myth 1: "It's just tight calves"

While tight calves definitely contribute, tendinopathy involves actual structural changes in the tendon. It's not just a flexibility issue.

Myth 2: "Just rest it and it'll go away"

Plot twist: Complete rest often makes tendinopathy worse! Tendons need the right kind of movement to heal properly.

Myth 3: "Anti-inflammatory pills will fix it"

Since tendinopathy isn't primarily inflammatory, these medications are not likely to 'fix' the problem.

Myth 4: "I can just push through it"

This is like ignoring your car's check engine light and hoping for the best. It rarely ends well.

When Should You Actually Worry?

- Pain that sticks around for more than a few days

- Morning stiffness that won't quit after 30 minutes

- Pain that's getting worse instead of better

- Any visible changes to your tendon

- When it starts messing with your daily life (not just your running)

The Good News!

Here's what I tell my patients at Endurance Therapeutics: Achilles tendinopathy sounds scary, but it's totally manageable when you catch it early and approach it right.

What to Expect:

Early cases: 6-12 weeks to feel significantly better

Stubborn cases: 3-6 months

Really persistent cases: Up to a year, but we'll get there!

The key is addressing the WHY behind the problem, not just the symptoms. It's like fixing the leak instead of just mopping up the water. This is where coming in to get a gait analysis can help break down what is happening during running. We can also take a look at any muscle imbalances which could be causing compensation making the injury more chronic.

Reach out today for more information or for an assessment!

Coming up in Part 2: How to actually fix this thing and get back to doing what you love!

Got a cranky Achilles tendon that's cramping your style? Dr. Keirstyn specializes in getting endurance athletes back on track without the drama. Let's chat at our Oakville clinic!