Achilles Tendinitis - Trigger Point Therapy
Achilles problems are amongst the most common issues that therapists deal with every day - especially with clients who are regular runners or walkers
In many cases, poor footwear or a change of footwear to a new design, is the cause.
Trigger points form to weaken muscles of the calf in particular, creating a chain effect and ultimately additional trigger points and a reaction in the achilles.
Trigger Point Treatment Protocol
Trigger point therapy can be wonderfully effective for treating achilles issues.
Here (video above) we demonstrate the most commonly used NAT trigger point protocols for treating achilles tendinitis.
Bear in mind that we're only showing brief highlights of the treatment process and do not attempt to perform these trigger point techniques unless they fall within your professional scope of practice.
Achilles tendinitis is typically associated with trigger points in the gastrocnemius, soleus, and plantaris muscles.
Achilles Tendinitis - Overview
The Achilles tendon crosses the back of the heel, which means it rides over the bone as the muscle contracts and stretches.
Inflammation of the Achilles tendon can be very painful; all of the body’s weight is supported by this structure and footwear often presses against this area.
Repetitive stress to the tendon can lead to inflammation that causes additional irritation and further inflammation.
Activities such as basketball, running, volleyball and other running and jumping sports can lead to Achilles tendinitis.
Repetitive contraction of the muscles in the calf and improper footwear or excessive pronation of the feet can lead to inflammation in the tendon.
Cause of Injury
Repetitive stress from running and jumping activities. Improper footwear or awkward landing pattern of the foot during running. Untreated injuries to the calf or Achilles tendon.
Signs and Symptoms
Pain and tenderness in the tendon. Swelling may be present. Contraction of the calf muscle causes pain; running and jumping may be difficult.
Complications if Left Unattended
Inflammation in the tendon can lead to deterioration of the tendon and eventual rupture if left untreated. Inflammation may lead to tightening of the tendon and attached muscle which could lead to tearing.
Rest, reducing or discontinuing the offending activity. Ice. Anti-inflammatory medication. Trigger point therapy. Then heat and massage to promote blood flow and healing.
Rehabilitation and Prevention
After a period of rest, usually lasting 5–10 days, gentle stretching and strengthening exercises can be initiated.
Heat may be used on the tendon before activity to warm the tendon properly.
Adequate warm-up, along with strengthening and stretching exercises for the calves, will help prevent tendinitis of the Achilles tendon.
Tendinitis seldom has lingering effects if treated properly. Tendinitis may take from five days to several weeks to heal but rarely needs surgery to repair it.
If you are receiving any form of trigger point therapy, either self-help or with a therapist, it is advisable to stretch on the hour, every hour, on the day of the treatment and then three times per day thereafter for a few weeks to several months.
Below you'll find some useful self help techniques.
Stand upright and lean against a wall. Place one foot as far from the wall as is comfortable and make sure that both toes are facing forward and your heel is on the ground. Keep your back leg straight and lean towards the wall.
This stretch can put a lot of pressure on the Achilles tendon. Ease into this stretch by slowly lowering your heel in a carefully controlled manner.
Muscles being stretched
Primary muscle: Gastrocnemius.
Secondary muscles: Tibialis posterior. Flexor hallucis longus. Flexor digitorum longus. Peroneus longus and brevis. Plantaris.
Injury where stretch may be useful
Calf strain. Achilles tendon strain. Achilles tendonitis. Medial tibial pain syndrome (shin splints).
General self help tips
There are many reasons why you might have trigger points, so it is important to consider your trigger point pain in the context of the rest of your body.
It must be stressed that the techniques offered on this page are not a substitute for therapy from a qualified practitioner.
Although aches and pains from trigger points are common, there can sometimes be an underlying pathology.
It is advisable to always seek a proper diagnosis from a qualified medical practitioner or suitably qualified manual therapist.
Gastrocnemius - Common Trigger Point Sites
Soleus - Common Trigger Point Sites
Self help trigger point massage
This technique involves locating the heart of the trigger/tender point. When this is compressed it may well trigger a specific referred pain map (preferably reproducing your symptoms). This technique involves applying direct, gentle and sustained pressure to the point, as follows:
1. Identify the tender/trigger point you wish to work on.
2. Place the host muscle in a comfortable position, where it is relaxed and can undergo full stretch.
3. Apply gentle, gradually increasing pressure to the tender point until you feel resistance. This should be experienced as discomfort and not as pain.
4. Apply sustained pressure until you feel the tender point yield and soften. This can take from a few seconds to several minutes.
5. Steps 3-4 can be repeated, gradually increasing the pressure on the tender/trigger point until it has fully yielded.
6. To achieve a better result, you can try to change the direction of pressure during these repetitions.
About NAT Courses
As a manual therapist or exercise professional, there is only one way to expand your business - education!
Learning more skills increases the services that you offer and provides more opportunity for specialization.
Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.
About Niel Asher Education
Niel Asher Education is a leading provider of distance learning and continued education courses.
Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.
Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.
Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).
NAMTPT AWARD 2017
We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.
Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.
Award Winning Instructors
Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.
If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.
In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.
There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.
Most of our courses are accredited for CE/CPD/CPE. A full list of CE accreditations can be found by clicking on the link below.
Niel Asher Technique
Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.
The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.
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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
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