Achilles problems are a significant issue for athletes at all levels. Often the result of a sudden increase in quantity or intensity of training Achilles tendonopathies are often slow to resolve even if the protocol for resolving them is followed rigorously. This is frequently because the maintaining factor itself has not been resolved. This will most commonly lie in the gait pattern and foot mechanics. Tendons are generally very happy being stretched longitudinally. However, torsion or bending of tendons will cause trauma to the tendon. This then becomes infiltrated with new vascular and neurological tissue, so that a previously pain free tendon starts to experience pain. It is now recognised that to remove the pain and stop recurrence you need to breakdown the new neurovascular tissue that has infiltrated the tendon and address the maintaining factor, namely adjusting the foot and gait mechanics for irregularities. Addressing the fascia surrounding the external compartment of the calf is also essential to combat severe Achilles tendonopathies.
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