Tendon Compression (Achilles) by Chris Mallac


 
I suppose the main message we are trying to bring forward with this series on Tendon Compression locations around the human body is simply that:

Biomechanics matter more than Pathology! 

The main problem with each of these sites of compression is not the pathology within the tendon, but the surrounding factors. Technique issues, muscle imbalances, weakness of surrounding musculature, etc - these factors are generally under-rated in the whole world of therapy. So many therapists simply stick a needle in there, apply the ultrasound, massage the hell out of it, etc etc…but its all a bandaid to the real issues underlying. The iceberg mainly lives under the surface, and needs understanding.

Achilles Tendon
  Chris Mallac

  The achilles can be subjected to two compression zones. The first is the calcaneus bone at the insertion of the achilles. In dorsiflexion, the achilles winds around this bone. This is referred to as "insertional achilles tendinopathy."

The other site of compression is 3-6cm above the insertion in the mid substance of the achilles. There is no bone here that compresses the tendon, What may cause compression here is the heel counter of a shoe (particularly hard leather shoe such as football boots). The other compression factor here is the soft tissue retinaculum that wraps around the achilles. This may compress the tendon in dorsiflexion.

So, biomechanically the main issue that will affect Achilles is “eccentrically loaded end of range dorsiflexion”. If its inflamed you even have to limit stretching of the Achilles as it will compress it onto the calcaneus (heel).

Ohhh you know what?... The amount of material I could write about how to effectively address this common complaint is ridiculous! It makes me think it is worth a series in itself: The Achilles Tendon Series….does that interest you at all?

Suffice to say there is sooooo much you can do. Without any lasers, ultrasounds, needles, massage, or even doctors visits. Yep!

I’ll give you two teaser pictures to lead you in the direction we want:

How to get them out of pain:


How to train / re-educate the client:

Keeping it all a secret until our Achilles Tendon Series (which will be after our next series on Maintaining Mobility with the Stretchband). I’ve just decided!

Finally, last week’s quick Quiz on Adductor Tendons:

How can we reduce Adductor Tendon compression at the Adductor Tubercle of the pelvis? 
  • Work on Pelvic stability by targetting the deep abdominals (nothing beats the Pressure Biofeedback that all our Master Rehab Trainers are trained in using) - will reduce excessive anterior or posterior tilt during the wind-up and follow-through to the kick.
  • Loosen the deep posterior hip musculature (e.g. Piriformis muscle and Hip capsule), because poor mobility there will prevent the Femoral Head from posterior gliding as the kick follows through) and release the Adductors themselves, as tightness there will certainly mean the tendon is tensioned excessively.
And..any suggested coaching technique cues that might reduce the problem?
  • Again I’m not a football or martial arts coach, but assessing if there is varying levels of pain with various amounts of twist of the hips when going to kick - i.e. when the hips are very square to the kick, or very side-on. Or with different amounts of foot turn-out or not - can they train out of the positions that produce more pain, or at least not perform these painful kicks until their biomechanics have improved?
Phew - deep stuff ;) hope that is useful for all those of you who wrote in with keenness on this issue. 

What in the fitness industry or gym is aggravating groin pain - can you shed light on it?

All the best!

Ulrik

Last chance for Brisbane EssentialsMelbourne Essentials filling fast…  

 
      

 
       

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