How Shockwave Therapy Helps Runners Recover from Achilles Tendinopathy
There's nothing scarier than Achilles tendon injuries for runners. Achilles tendinopathy accounts for one of the most common overuse injuries in runners. Up to half of all runners will experience Achilles tendinopathy. Since the Achilles tendon takes so long to heal, weeks or even months out of running can be discouraging. Luckily, shockwave therapy can help runners recover from achilles tendinopathy faster.
What is Achilles Tendinopathy?
Before we get into shockwave therapy, let's make sure everyone is on the same page about Achilles tendinopathy. When did you first notice that annoying pain in the back of your ankle? What can you do about it?
Tendinitis vs. Tendinosis: What's The Difference?
You may think that you have Achilles tendonitis. However most achilles tendinopathy in runners is actually tendinosis.
Tendinosis is not an acute injury with inflammation. Rather it is a slow degenerative process that is characterized by:
- Failure of collagen fibers to line up neatly
- Microscopic tears that have failed to heal
- Thickening of tendon with nodules
- Diminished blood supply to injured tissues
Treating tendinosis like tendonitis just doesn't give you the results you want.
Why Rest and Ice Don't Work
When you have chronic tendon degeneration and failed healing attempts, rest isn't going to fix it. Yes, your body has an innate ability to heal injured tissue. But remember that tendons LIKE to be loaded. They NEED movement and exercise to trigger healthy rebuilding.
In order to repair achilles tendinopathy in runners, your body needs to be prompted to create healthy tissue to replace the degenerative tissue it can't heal on its own.
Why Shockwave Works for Achilles Tendinopathy Treatment
Shockwave therapy has been a game changer for treating chronic tendon injuries. Let's break down how and why it works.
How Shockwave Works Scientifically
Despite the name, shockwave therapy does not use electricity. Shockwave therapy uses acoustic waves to penetrate injured tissue. Here's how that helps heal achilles tendinopathy:
- Breaks up scar tissue
- Lyses up calcification and fibrotic adhesions
- Clears out haphazard collagen
- Creates space for healthy granulation tissue to repopulate the area
- Stimulates collagen production
- Activates tendon stem cells
- Releases growth factors
- Promotes healing
- Orthograde loading of new collagen fibers
- Hyperstimulates pain receptors to "turn off" chronic pain
- Improves blood flow and addresses hypovascularity
Achilles Tendinopathy Treatment Plan
What does Shockwave Therapy Treatment actually look like?
Shockwave targets the location that is injured:
- Insertional Achilles tendinopathy (where tendon inserts on bone of heel)
- Mid-portion Achilles tendinopathy (middle of Achilles typically 2-6 cm above insertion on heel)
- Approximately 2000 impulses over 15 minute period
- Minimal discomfort. No anesthesia or medications necessary
- Typically combined with continued running but at LESSENED volume
Load Management Isn't Quite Rest
Okay so you're undergoing shockwave treatment for achilles tendinopathy in runners. Does that mean you still have to stop running? Not necessarily!
It's all about finding that sweet spot of training that allows you to maintain your fitness while NOT worsening your tendonitis. Here's how to do it:
- Decrease overall mileage volume by 30-50%
- Avoid speedwork and hills for the time being
- Continue running easy miles as long as pain remains a 3/10 or less
- Use morning pain/stiffness as a barometer for too much stress on tendon
- DO NOT INCREASE mileage until after shockwave treatments are completed
Combine shockwave therapy with Eccentric Loading
Remember our tendon likes to be loaded! One of the most critical pieces of your recovery from Achilles tendinopathy is serial loading of the tendon with eccentric exercises. The most widely used protocol is still the simple heel drop:
- Place affected foot on edge of stair with heel hanging off
- Rise up onto both legs to full standing position
- Shift weight to injured leg
- Slowly lower injured heel below stair over course of 3-5 seconds
- Repeat for 3 sets of 15 repetitions twice per day
By combining shockwave therapy with Eccentric loading exercises, you're hitting the injury from two angles:
- Shockwave starts the tissue healing process on a cellular level
- Eccentric loading builds the mechanical strength of tendon needed for recovery
If your achilles tendinopathy is caused by poor core and hip strength. The great news is you can treat your Achilles tendinopathy while strengthening the very things that led to your injury with Pilates.
Consistency Strengthens the Kinetic Chain
Runners don't have weak ankles. They have weak hips, cores, and glutes. These shortcomings force the calf muscles to overcompensate, placing unbearable strain on the Achilles.
Strengthening the kinetic chain reduces the load on your Achilles by:
- Improving glute strength to reduce overstriding
- Correcting core strength to realign pelvic drop
- Balancing out hip strength on the front and back of your leg
- Improving proprioception to reduce injurious movement patterns
The Ironhorse Physical Therapy Difference
Most clinics will throw some blood on your achilles and send you on your way. But here at Ironhorse Physical Therapy & Pilates, in San Ramon, we want to treat both the symptom and the cause.
By combining Pilates with advanced therapies like shockwave, you can rebuild your strength while recovering from injury:
- Speed up tissue healing from the inside out
- Correct the underlying biomechanical contributors to your injury
- Develop the strength necessary to prevent future overuse injuries
- Return to running confident in your body's ability to perform
How Do I Know If Shockwave is Right for Me?
As with any medical treatment, you should speak with your doctor. However, many patients who suffer from Achilles tendon pain find relief with Shockwave Therapy. Click here to Contact Ironhorse Physical Therapy and speak with someone today!
It's Time to Run Pain Free Again
We know every runner has a different story, but everyone has the same goal. You want to run without pain again. Here at Ironhorse Physical Therapy our goal is to help you achieve that goal and return to the activity you love faster than you thought possible. With cutting edge treatments like shockwave therapy your recovery doesn't have to be long and grueling. Contact Ironhorse Physical Therapy today to start living pain free again!
FAQs
Can shockwave therapy cause you to rupture your Achilles tendon?
No. Research has shown that shockwave therapy does not cause structural damage to the Achilles tendon. However if you have a complete rupture of your Achilles tendon you should not receive Shockwave therapy.
How soon after the shockwave can I run?
You should avoid running for 24-48 hours after receiving shockwave therapy. However, most athletes can participate in light cardiovascular activity the same day of treatment.
Does shockwave therapy work for old injuries?
Yes! Shockwave therapy works by jump starting healing at a cellular level. This is why it works so well for those nagging injuries you just can't seem to get over.
What is the difference between radial shockwave vs. focused shockwave?
Radial Shockwave is great for more superficial injuries because the energy spreads out as it travels deeper into the tissue. Focused shockwaves can target deeper tissues because the energy is focused on a specific focal point. Both types of shockwave can be used to treat Achilles tendinopathy.
Do I need a doctor's referral for shockwave therapy?
Most insurances will require you to be seen and evaluated by a clinician before receiving Shockwave therapy. However, you do not need a doctor's referral to be seen at Ironhorse Physical Therapy.
