Inactivity decreases your tendon’s capacity
If you have a long period of lazing around and not doing much exercise or you just have a break from running the capacity of your muscles, tendons, bones etc decreases. It’s literally a case of if you don’t use it, you slowly start to lose it. Having a rest from exercise is fine but when you return making sure that you do so gradually is key. The use of apps such as Strava to monitor your weekly mileage if you sport is running or cycling is really useful. It's also important to think about managing your intensity and including some easy training sessions.
Injury happens when you exceed your tendon’s capacity by too much
Achilles tendonitis or tendinopathy develops when you do exercise that exceeds the capacity of your Achilles tendon and do not give it enough time to repair itself. This causes the micro-trauma to accumulate, sending your tendon into disrepair. Ensuring you have rest days is an essential part of reducing the risk.
Once injured, your Achilles tendon’s capacity to cope with work and load dramatically decreases. Before the injury you may have been able to run up hills, but once injured you may struggle to walk up a flight of stairs without aggravating your tendon pain.
That’s why a big part of our treatment is always to establish exactly what your Achilles tendon’s capacity is at this moment in time. This is individual to you, your activity and your goals.
Often people try to strengthen their Achilles tendon, but report the exercises had made their pain worse. This usually happens when you are prescribed the wrong volume of exercise (that exceeds the capacity of your injured Achilles tendon). It could also be that your tendon is being underloaded i.e. not strengthened enough. Your exercise prescription should be very different if your goal is to run a marathon compared with a gentle dog walk.
Another problem we see is that the achilles problem has not been diagnosed by a professional. Self diagnosis is very difficult as there are many sources of pain including the achilles insertion, mid tendon, paratendon, soleus muscle and nerve related pain.
There is no one-size-fits-all and we have to work out the total volume of load that the exercises and other activities in your life will place on your tendon. This then allows us to design a strength training programme that is at the right intensity for your injured tendon.