Tendon pain in the lower limb is particularly common among recreational runners and running based sports. While our lower limb tendons are generally quite adaptable and can withstand a consistent level of loading, issues may arise when load (either intrinsic or extrinsic) becomes too excessive or changes in nature.
Intrinsic load includes factors such as local muscle strength & length as well as joint mechanics and joint function.
Extrinsic load refers to factors such as running volume & speed, footwear, running surface etc.
Rapid changes in any of the previous mentioned factors can impact tendons by challenging the strength of the tendon.
Current research and clinical experience suggest that lower limb tendons can respond poorly to both compressive and tensile load.
Compressive load refers to the stretch on a tendon applied when the adjacent joint is under load. For example, with an achillies tendon when lunging or stretching over the edge of a step.
Tensile load refers more to when the tendon itself is producing force and under load. As an example, for the patella tendon, while pushing off during squats or box jumps.
Rapid increase or changes to either of these conditions can contribute to the onset of tendon pathology and pain.
Tendon symptoms or pathology can present at various locations within the tendon itself.
Mid portion tendinopathy is perhaps the most common in terms of location, and occurs within the middle fibres of the tendon.
Insertional tendinopathy occurs at the attachment of the tendon to the bone eg heel or knee cap
While the management for the varying locations may vary subtly, many management principles and strategies remain largely similar.
The current severity of the tendinopathy and its impact on function will largely dictate the strategies your physiotherapist will adopt to guide your management.
Initial management will look to reduce your symptoms and get on top of the pain and improve your function.
From there your physio should look to restore the tendons capacity to tolerate load through rehabilitation and progressive strengthening.
Return to running and sport will also be discussed and mapped out effectively to ensure the long-term health of your tendon.
For those currently experiencing lower limb tendon related symptoms please contact the clinic on 0395695799 or www.energizestudio.com.au to arrange for a consult with one of our physiotherapist. If unable to attend a face-to-face session, recent changes to private health rebates on telehealth (video conference) consults gives a great opportunity for a session in the comfort of your own homes.