Achilles Heel of Football

By Craig Steele

With pre-season training well behind us, all football codes have strapped the boots on for the first couple of rounds and we are already seeing leg strains and injuries from both acute injuries and overuse injuries. Achilles tendon issues have been prevalent in these first few weeks of the season, as a result of training issues related to training surface and biomechanics along with training loads.

Most infamously we have recently seen the golden boot of David Beckham suffer an Achilles rupture, requiring surgical repair. His injury was not one of those acute sprains but rather an acute presentation of a long term degenerative condition of the Achilles tendon. The condition usually presents itself through a footballer’s career as episodic strains of the Achilles tendon known as “tendinosis”, and occasionally there is inflammation in the lubricating sheath of the tendon. The term “Achilles Tendinitis” is really a misnomer, as the tendon does not get inflamed itself but rather the surrounding structures. This repetitive micro-trauma of the tendon without adequate healing leads to the chronic condition of tendinosis, whereby the tendon suffers gradual degenerative breakdown. This is also true of all tendon structures of the body including the knee and shoulder.

Achilles tendon pain associated with an acute episode is due to inflammatory swelling around the tendon and poor tolerance of the tendon to further exercise loading. This is what we have been seeing in the early stage of the football season for all codes and is managed through appropriate treatment of causative factors and relative rest over the short term. However, it is the long term management that prevents progression of tendinosis into chronic, crippling states that may even progress to tendon tears or rupture. Physiotherapy is the mainstay of management for all tendon injuries that have not progressed so far along this injury continuum to require surgical intervention. Typical forms of treatment from a sports physiotherapist include massage, stretches, acupuncture and taping to deal with the acute presentation when there is swelling and inflammation in the surrounding tissues. But the keystone to good sports physio management is diagnosing the causative factors and assisting in future management of these issues when identified.

Experience with the different codes of football allows for greater understanding of the forces placed upon the lower limb during sport and the training requirements for coping with these strains on the Achilles tendon. Ultimately the recovery of the tendon relates to the strength and endurance of the whole leg as well as the core muscles of the hip. Flexibility is also an important issue for lower limb strength and stability during running and turning in football. For prevention or recovery from an Achilles tendon injury it is essential to address biomechanical issue arising from the foot and the dreaded footy boot which on average still lacks adequate support for the athletic foot. This often requires the correct fitting of footwear / boots and can even require intervention from orthotics inside the shoe to control poor foot posture and biomechanics.

If you have any concerns about your Achilles Heel or any other tendon injuries please contact an appropriate health professional. Craig Steele is a sports physiotherapist working at Hinteractive Physio in Cooroy and can be contacted on 5442 5556.

On April 12th, 2012, posted in: Legs by

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