The Achilles tendon is one of the most active parts of the body. Beginning at the calcaneus—or heel bone—the tendon extends up the lower leg and connects to the gastrocnemius and soleus muscles in the calf, helping to enable almost every action that involves foot movement, including walking, running, and jumping.
While it is the strongest tendon in the body, the sheer workload placed on it means that some wear and tear is inevitable. As a result, massage therapists often find that Achilles tendon injuries are a common problem for patients, with complaints ranging from mild aches and pains to more severe tears and inflammation.
Fortunately, with proper assessment and care, massage therapy can be a useful complimentary treatment for all types of Achilles tendon issues.
Achilles tendonitis can be broadly classified as either insertional or non-insertional. Insertional tendonitis occurs at the point where the tendon inserts into the heel bone, and is usually the result of minor damage in the area which fails to heal properly.
This occurs because of a region near the distal insertion known as the avascular zone, which has a very poor blood supply, meaning it can be easily inflamed through simple everyday activities. Insertional tendonitis is particularly prevalent among older patients.
Non-insertional tendonitis occurs in other areas of the tendon, and is more common among those who engage in more strenuous physical activities, such as athletes. Massage school graduates will treat a number of different types of non-insertional tendonitis, including paratendonitis, which is the inflammation of the paratenon, and tendonosis, which is the result of small tears in the collagen surrounding the tendon.
At OVCMT we expose students to multiple treatment experiences, including geriatric, sport, pre/post surgery and orthopedic conditions.
Students in therapeutic massage courses learn a number of techniques which can be beneficial to patients with Achilles tendon complaints. Friction therapy, where pressure is applied in small circular movements, usually with just a couple of fingers or the thumb, is commonly used by RMTs to break down painful adhesive scar tissue which may have built up around the Achilles tendon.
Myofascial release can be performed on the calf muscles and the area surrounding the tendon to stimulate blood flow and aid recovery. After a couple of weeks of treatment, many RMTs will also incorporate stretching techniques into a patient’s program. These will usually involve a brief series of gentle stretches for both the tendon and the calf muscles, helping to strengthen the area and prevent further scar tissue from forming.
Partial or complete rupture of the Achilles tendon is usually caused by a sudden forceful movement which places too much stress on the calf muscle, making it a common problem for athletes. It can also be the result of chronic tendonitis which has not been properly treated.
Ruptures can take a long time to heal and often require surgery. Usually, an RMT will not attempt massage on a patient who has had surgery to fix a rupture until around 8 weeks into their rehabilitation program. However, once the patient can tolerate treatment, gentle massage to stretch and relax the calf muscles and take the strain off the tendon can be quite beneficial.
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